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Chris is an experience expert looking back on a history of heavy psychoses and several lesser ones. His psychotic vulnerability also comes with depression. Here he tells everything he knows about the origins of his psychotic episodes and how he experienced his first one.

“Looking back, I can remember the general picture of my first psychotic episode, along with a number of specific details. That’s because afterwards, I often reflected and thought about that first psychosis.

Let’s start a few months before my first encounter with psychosis. Lately, I’ve been feeling very insecure and restless. One important source of this discomfort is my sexual orientation. Although some role models on tv are already breaking the taboo in a comical way, I still consider homosexuality a very sensitive topic. Friends and classmates make jokes about ‘gays’ and imitate them in a funny, but also mocking way. Although I have lots of nice friends, it makes me feel lonely and confused. And so I hide my true nature.

A week before my first episode, I’m staying over with my uncle in The Hague for a few days, to visit an introduction day of the nearby European Studies academy. I’ve set my eyes on this education as the next step after getting my secondary education and Bachelor certificates. But first, the plan is to do a year of High School in the United States. My whole life is set up for the coming three years.

While staying at my uncle, I can hardly sleep. I lie awake the whole last night

When I arrive at the university’s introduction day, I am already confused. And thus I end up in a classroom of the Cultural Sciences programme, with a lecture on China. I was clearly completely lost!

I leave the university thinking that they sent me in the wrong direction on purpose: they must have been fully prepared for my arrival! That same afternoon, I meet my cousin for a visit to the harbour. While walking over the boulevard, I sense that every man we pass is secretly watching me. It’s only the first phase of my psychosis, so I can still function properly. The next day, I go and visit the Dutch parliamentary building. Later that evening, I watch the news and see a State Secretary in tears, announcing her resignation. For me, the connection is totally clear: I was at the political centre today, so her resignation can only be my fault!

I return home on Friday evening. On the train, I’m sure that my uncle and aunt have followed me and are watching

The nights before, at my uncle, I hardly got any sleep.

On Saturday, morning my parents notice I’m having a psychosis. They call our doctor, who comes over and redirects us to the local mental health emergency service. We can see them on Monday. Until then, the Xanax he gave us should calm me down a little.

But the psychosis only gets worse over the weekend. Without telling my parents, I leave to take a swim in the local outdoor pool. On my way, I keep meeting people who I think I know, yet without recognizing who they are exactly. Some meet me with angry faces, which is because we are about to leave the country and they can’t come with us. All these confusing and scary impulses make me decide to turn home quickly.

Back home, I pick up the newspaper. The front page has pictures of tanks ready to leave for Yugoslavia, which is currently in a civil war. This only makes me more fearful and psychotic. I think that the war in Yugoslavia is under my direct control. Any driver with sunglasses passing our house, is sent to monitor me, because I have something to hide. From the building behind my parents’ house, I imagine, my former teachers are watching me through binoculars. The tv is not only showing me the world; it’s a camera through which the whole world is also watching me.

The bathroom is wired with microphones. My fears are taking over and I dare not leave the living room couch

On Monday, it’s time to see the youth psychiatrist. In my delusions, I think we are bound to leave for the USA with a large group of Dutch people. Because we’ve had enough of the country, we are now secretly discussing the plans for our departure.

The meeting with the youth psychiatrist is, in my perception, a test to decide if we are allowed to join the group. Therefore I say as little as possible, which seemed the safest bet to me.

The next day, I’m admitted to the psychiatric ward of the general hospital in Maastricht

I’m given many different kinds of medication, which makes my body incredibly stiff. Yet the psychosis doesn’t get any better. Hearing the sound of the ventilation, gives me the idea that helicopters are landing on the hospital roof to take me away to America. All my friends and family will be waiting for me there, ready to start a new life. Everyone I see at the ward is a source of danger. The nurses are not to be trusted either. Sometimes I calm down a bit due to the medication, but the psychosis remains.

One day, two of my friends spontaneously come to visit me. I have no idea what to do with them, and hardly speak. Several days later, our neighbours also come over. Sharing thoughts with anyone, in any way, turns out to be impossible. During creative therapy sessions, nothing comes out of my hands.

By my own instructions, my parents ask if there’s any possibility to continue my treatment as an outpatient, because I ‘m feeling very unhappy in the hospital and don’t seem to get any further here. Treatment at the hospital still lasts for a week, after which I’m redirected to a youth psychiatry facility.

During the intake in the youth psychiatry clinic, with my parents next to, my psychosis is getting serious

We are in the middle of a conversation with the youth psychiatrist. But I can’t get a word out of my mouth, being convinced that everything I say will be used against me. I utter some confused and unintelligible remarks. My parents and the psychiatrist decide together that I will be admitted in two weeks.

Before my stay at the clinic, we first go on a holiday at the Belgian coast for a few days. My parents hope that this trip will give me some rest and help me recover a bit. During the drive to our destination, I believe that the ‘great leader’ arranged for us that all our traffic lights turn to green. He has Belgium and most other countries under his command. The people of these countries live in fear and misery. The Netherlands remains largely independent, and so do its citizens, but here too we are slowly falling under the control of this great leader.

In these three days, I do not have the courage to step outside our holiday apartment

One time only, I make an exception and join the others at the beach. But it’s not long before I flee back inside. The pier has a number of windmills, and they obviously control the weather. There’s a strong wind, directed by the power-hungry dictator to make the people suffer. Citizens are also secretly medicated, with chemicals inside the baker’s bread, in tea, coffee, milk, to keep everyone obedient. As a consequence, I hardly eat anything and get very skinny. The tv news, radio broadcasts, the newspapers, they are all reporting on me, and otherwise about events on which I have an influence. My antipsychotics are clearly not working. The paranoia, fears and suspicions are still far too strong.

Two weeks after, my father brings me to the youth psychiatry clinic

During that journey, my delusions tell me that the tunnel under the river we are driving through is leaking. And again, someone is turning the traffic lights to green for us.

The clinic is very new and modern, with four departments. One for children under 12, and three for teenagers between 12 and 18. The departments are named after constellations, and mine is called Orion.

During the admission, you can switch to another department with more freedom. Each one has his own inner court, with a stone ping-pong table.

I have a room for myself, but spend the first nights in the isolation room. Later I’m free to sleep where I choose. The isolation seems best, because I’m safe there.

The isolation has two separation rooms, painted completely white both inside and outside, with a steel door. Cameras inside are used to monitor me from the nurse’s room. There are no windows, only air conditioning.

My psychosis makes it very hard to find my way around in the bungalow-like building. For weeks I thought that my room was put away far in the back, until I found out it was actually right next to the staff room, and thus at the centre of the department. It had that typical, slightly chemical smell that new buildings often have. My belief was that these were chemicals to tranquilise us.

I suspect practically everyone, the care worker as well as my fellow patients. I prefer to spend the days in my own room, but that is not allowed. They try to encourage me to join the group for sports or swimming. Sometimes I am also accompanied to go shopping at the nearby neighbourhood. On our way home, we pick some grass and weeds to feed the rabbits at the nearby farm.

The park-like environment, with a pond, small hills and ditches around the psychiatric ward, is a mysterious and treacherous domain to me, filled with swamps that harbour all sorts of creepy scenarios.

In the weekends, I’m not allowed to go home. Mornings are for swimming with the group and afternoons for eating pies and drinking tea. Before my psychosis, I used to love swimming. Now I hate it. The mental illness has robbed me of every joy in life.

We also go for walks near the clinic. The medication makes me stiff as a bone, while I’m still thinking that military planes from a German NATO base are spreading nuclear energy. That would explain the stiffness of my body, and I lose faith in my ability to walk. I completely freeze up. Luckily, the walks are sometimes easier than usual, but there’s always the chance I suddenly get paralysed and cannot take another step.

We’re watching the evening news: the king of Belgium has passed away during his holiday; my family must be behind this

The king did not fit in the ‘ new world order’ that is about to come. The television shows the new president of the United States. I’m afraid they are going to kill him soon as well, just like Kennedy.

The referential delusions that make me think anything in the newspaper, on tv and radio is about me… The phantom smells. The nightmares of which I think they really happened. The delusions of being followed. Distrusting anyone… It all won’t go away. Clearly the medicines I’ve been taking since my admission, Akineton, Impromen and Tranxene, have not kicked in sufficiently.

On month onward, in August, after some hesitation, they decide to put me on Clozapine/Leponex. This medicine has reappeared on the market recently, after a history of people getting seriously ill because Leponex can damage red and white blood cells. It is now allowed to be prescribed again, but only with blood tests every two weeks. The psychiatrist is willing to take the risk of lowered blood cells, since the chance is about one in ten thousand. The Leponex is increased over two weeks to 600 mg per day.

Suddenly, my psychosis melts away immediately. The following weeks, I’m still having some after-effects. For instance, when I ask my mother when I am allowed to go home on Sunday. Or at the yearly art fair in Maastricht, where I think that everyone on the streets can recognise me. My mother says it’s nonsense. This delusion, a light one compared to my recent heavier psychoses, luckily fade away quickly after talking with my mother.

The downside of Leponex however, is that I sleep like in a coma within half an hour, for twelve dreamless hours straight. Gaining 15 kg of weight and the nightly drooling are things I’ll just accept.

Now that I’m doing much better again, I also become much more active. I’m even starting to feel bored at the hospital ward. Luckily, I can spend the weekends at home by now. I ask my supervisor and hospital staff if I might go to the adjacent school for special education. They agree, and two weeks later I am allowed to go to school for three hours a day. Here I take Dutch and English classes at entry-level, which is going quite well.

In the step-by-step-programme, which determines the degree of freedom for young people in admission – I’m still stuck at step 2. Step 1 is the least amount of freedom – you cannot leave the building – while step 12 means full freedom. As I experience, this lack of freedom is seriously preventing my recovery and further personal development. And thus I make repeated requests to get to a higher step, but this is refused every time. Additionally, the youth psychiatrist decided I have to stay in the youth psychiatric hospital until Easter next year, 1994. To me, as it would for every teenager, this seems like an eternity.

The hospital ward is very turbulent, as some youngsters have ADHD and related disorders

At the dinner table, most of the others are complaining they don’t like the food. During resting hour, the radios from their rooms play at full volume. Not what I need to calm down and relax after such heavy and unsettling psychoses.

I am not happy at this facility, where I miss my family, friends and my familiar home environment. I just want to live like any 17-year old high school student, along with all the ups and downs that come with life.

In the first weekend of November, I return home as always. I enjoy the warm homely atmosphere. That Sunday, I really don’t feel like returning to the hospital at all. And so I decide to stay in bed the next morning. My mother senses how I feel and also sees how homesick I am at the clinic.

The next day, my grandfather passes away at 93. I’m dealing with this loss pretty well, like any other ‘normal person’ would. This event does not throw me back into psychosis, which is another sign that I’m actually doing very well.

On 4 November, I decide to leave the hospital at my own initiative

We still have regular aftercare meetings every two weeks, but as a teenage rebel, I don’t care for them at all. The meetings thus never last more than 15 minutes. I just want to live my life again and leave behind everything related to psychiatry.

Because I strongly desire to go through life like any other normal boy, I also want to go back to school. Together with my former high school, we agree to be admitted to fourth class from January 1st. Unfortunately, this means I’m behind in my courses for over four months, and 450 mg of Leponex a day won’t make it easy to catch up. After about month, we notice that my delay is too much, and my presence in class is hardly of any value.

Some acquaintances who haven’t heard about my psychosis, keep asking me why I’m not in the United States. After all, was I not planning to do a year of high school over there? Until one time, a friend of mine answers out of the blue: “He has had a psychosis…” The person asking has clearly never heard of psychosis before.

The Leponex makes me very sleepy during the mornings, making me struggle to stay awake during class. My thoughts are slowed down and I find it very hard to keep up with the teachings. Only with lots of effort, I eventually complete the courses without getting a final evaluation.

Thankfully some of my friends support me a lot; the same friends who saw me during psychosis and came to visit me at the hospital

In June 1994, I radically quit my medication. I was fed up with the side-effects and with not getting to enjoy a beer on Saturday nights. After several days already, I notice I’m getting more active and losing weight. At parties, or at the pub, I can also have a beer, like anyone else of my age. I enjoy life again, like it was a few months before the psychosis. And I’m making plans for the future again, such as doing my last two high school years simultaneously, to catch up with my friends and hopefully graduate at the same time.

When the Summer holidays have come, I greatly enjoy my freedom, compared to the locked ward that confined me a year ago. Without any medication standing by, I start the new school year with fresh confidence.

My conclusions after this first and also heaviest psychosis:

  • Does it run in the family?
    My mother’s family has many members who struggled with bipolar disorders, such as manic depression and schizophrenia. My psychosis vulnerability may thus well be genetically determined.
  • What trigger it?
    The extreme insecurity and stress over my personality. I didn’t know how to cope with my sexual orientation and the prospect of leaving to America for a high school year only added to my tension.
  • The learning point?
    Because this was my first psychosis ever, I was not yet able to correct myself, as I didn’t recognise the signs yet. They should have put me on Leponex much earlier, despite the supposed danger of blood cell disruption among people aged below 18.

Chris Zuidenberg (alias) is an experience expert. In the past, he has had several heavy psychotic episodes and several lesser ones, coupled with depressive episodes.

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