“My main recurring delusion is [that] I believe that I am Jesus Christ and that my job on this planet is to start the Second Coming. This is quite a serious problem to me when it happens because I have no idea where to begin,” 46-year-old Steven Swart told Health24.
Schizophrenia has been a part of Swart’s life for more than 16 years.
“Every time I lapse into psychosis, these delusions recur, and they just build upon the previous delusions and become even stronger,” says Swart.
Living with delusions
Swart was first diagnosed with the mental disorder in 2002, at the age of 30. The diagnosis came after a year of intense psychosis and destructive behaviour.
“Long before diagnosis, I was [always] a bit strange. There were times I recall when I would suffer from paranoid and delusional ideation, but at the time I didn’t recognise it as such; it just seemed normal to me,” says Swart.
"[I remember] one day, after I had been subject to disapproval for something I had done, I decided to take a large hammer to work. It was one of those large hammers usually used for things like masonry work. I spent the whole day walking around quite calmly with the hammer over my shoulder, not actually violent or threatening to anyone; in my mind it was just for self defence," he recalls.
Growing up in the 1990s, Swart became absorbed into the rave culture of the time. However, along with the rave culture came the notorious drug subculture.
“I attended a lot of parties, had a lot of fun and good times, and took a lot of drugs,’’ says Swart. “The drugs that really interested me were all the psychedelics like ecstasy, LSD, magic mushrooms and certain other things like nexus (2CB), to some extent GHB, and of course cannabis was ever-present.”
Swart has had his fair share of hospital visits. When he was first diagnosed, he had just been released from Sterkfontein Psychiatric Hospital in Krugersdorp. Since then he has found himself admitted to various open and lock-up wards in the Gauteng area.
Living with schizophrenia
Before his diagnosis, Swart completed his degree in electrical engineering at Wits university. Completing a few courses in computer programming over the years, Swart now finds himself working as a software engineer. After having explained his condition to his employers, Swart is able to work from home, as long as he logs 30 hours a week.
It’s been a couple of years since his last relapse, the last one occurring in 2013/14. Swart states that he has had two relapses since being diagnosed, i.e. in 2005 and 2013/14. He admits that both times were as a result of cannabis use.
Psychiatrist Dr Michael West previously told Health24, "In some studies involving people with bipolar disorder, cannabis use is associated with more frequent periods of illness, and shorter periods of wellness between episodes. The conditions where cannabis appears most harmful are the schizophrenia-spectrum disorders and bipolar disorder."
Due to there being no cure for his mental illness, Swart has to be on anti-psychotic medication for life. These include a monthly Fluanxol Depot injection and Risperdal, which he takes every night. As a state patient, Swart is required to visit a psychiatrist every six months for monitoring as well as for the renewal of his medical script.
Swart is not ashamed of his drug-tainted past. “One consequence of psychedelics is that they open up your consciousness and give you a much broader view of reality. I had some pretty good spiritual experiences as a result of this and it was the start of my spiritual journey. I have no regrets about it, but I later paid a heavy price for this.”
Comparing his moments of psychosis to his times of sanity, Swart states, “My path through life has included both sanity and insanity; both are my reality. I can tell you that I definitely prefer sanity, but in a strange way it has been the insanity that has given my life meaning. When one experiences altered states of consciousness, like when under the influence of psychedelics, or when in psychosis, the brain starts picking up 'other channels'. These can be very fascinating and beautiful to perceive, but when exposure to these 'other channels' goes on for too long, they cause immense confusion.”
Schizophrenia is a chronic mental disorder, characterised by delusions, hallucinations and distorted realities. Contrary to popular belief, schizophrenia is not a split/multiple-personality disorder.
According to a recent study conducted by Washington University School of Medicine, the disorder has been described as eight different mental disorders masquerading as one.
Lead researcher Claude Robert Cloninger, in a press release issued by the university, stated that “genes don’t operate by themselves. They function in concert much like an orchestra, and to understand how they’re working, you have to know not just who the members of the orchestra are but how they interact. What we’ve done here… is identify the way genes interact with each other, how the ‘orchestra’ is either harmonious and leads to health, or disorganised in ways that lead to distinct classes of schizophrenia.”
Schizophrenia has been identified in about 1% of the global population, and there are currently no cures for the disorder. Like many other diseases, schizophrenia can be divided into a spectrum. Some patients are able to live relatively normal lives, keeping their disorder under control, whereas others are required to remain in mental institutions.
Various studies have shown that although the use of illicit drugs does not cause schizophrenia, it may trigger the disorder in predisposed patients.
According to Dr West, "It is thought that the use of cannabis may double a person's chance of developing a serious psychotic illness (like schizophrenia). This increased risk seems highest among those with a genetic predisposition, and who consume strong cannabis, frequently, from a young age."
He goes on to add, "Taking MDMA (3,4-methylenedioxy-methamphetamine), commonly known as ecstasy, in a reasonable dose is safer than riding a horse... and it is not associated with psychosis. Very heavy use, over a long period of time, is associated with some reversible cognitive changes. All MDMA is ecstasy – but unfortunately not all ecstasy is MDMA. LSD was originally used to try and better understand psychotic states but does not cause psychosis by itself. There is a very small possibility that in an extremely vulnerable person, serious mental health complications (including psychosis) can arise from the heavy use of LSD and other psychedelics."
Diagnosing schizophrenia involves the examination of a patient by a psychiatrist. Due to symptoms of schizophrenia being similar to many other mental illnesses, the diagnosis of schizophrenia follows only once the doctor has ruled out the possibility of other mental illnesses. Symptoms may include delusions, hearing voices, the inability to complete tasks, among other things. The psychiatrist may look at a patient's family medical history or their history of substance abuse.
Treating schizophrenia depends on the severity of the disorder in patients. Some, like Steven Swart, are able to lead normal lives, where their only treatment involves taking anti-psychotic medication, and bi-annual psychiatry sessions. Others, however, may be confined to psychiatric lock-up wards for life to secure their safety and those around them.
Image credit: iStock