Definition of Crazy

Although recovery from schizophrenia is difficult, Will McMahon finds humor in his situation and uses it to help him cope.

Will McMahon has had paranoid schizophrenia since the age of nineteen when he started to hear voices in his head that told him to do harmful things.

A few days after Will McMahon’s 19th birthday, two strangers moved into his head and would not shut up.

McMahon was sitting in his home in Seattle the first time he heard the chattering of a voice that did not exist. “I walked around the house looking for him, and I couldn’t find him,” says McMahon. He thought the incident was odd, but ignored it.

Within days, the voices became impossible to ignore because McMahon heard their chatter without disruption. “It was always voices, and it was always two,” McMahon explains, casually rolling a cigarette. “They would just talk and have conversations with themselves sometimes. They would talk to me sometimes, and sometimes I would hear my own thoughts.”

Often, they ignored McMahon, and gossiped about him behind his back . . . inside his head. “It was general talking shit,” says McMahon. “They knew what I was feeling and they would use my feelings to make me feel bad.”

The voices were cruel. They ridiculed McMahon’s thoughts, convinced him that he was hurting other people, and tried to persuade him to kill himself.

This was Will McMahon’s introduction to schizophrenia.

Between 0.5 and 1.0 one percent of Americans are afflicted with schizophrenia, which typically emerges in young adulthood. Several forms exist, but the paranoid type that affects McMahon is most common. Paranoid schizophrenia is characterized by both auditory hallucinations and intense, persistent delusions.

“There are two kinds of delusions: delusions of grandeur and delusions of persecution,” says McMahon six years after the symptoms emerged. “I had delusions of persecution.”

McMahon’s delusions focused on a friend he says he was “psychotically in love with.” At first, he believed that she was in his house, hiding from him. Then he was convinced that she was sleeping with his roommates.

“It got to the point when I realized the voices were in my head, so I formed a belief that I was telepathically communicating with people inside my mind,” says McMahon.

Soon, McMahon says, his voices insisted that he was telepathically hurting the girl he loved, and they instructed him to kill himself to save her.

Psychiatrists don’t know what causes schizophrenia. The human brain appears to hold many doors to schizophrenia, and different keys unlock each one. Research indicates that genetics, early social environment, natural biochemistry, and the use of prescription or recreational drugs could play roles in the development of schizophrenia.

Will takes antipsychotic medication prescribed by his psychiatrist and sees a counselor to help with the voices.

While they don’t understand precisely how the disease is caused, scientists have discovered that schizophrenic individuals have uncharacteristically high levels of the neurotransmitter dopamine in the pathway that affects the human response to feelings of reward. Doctors have found that suppressing dopamine activity with antipsychotics can help quiet the symptoms of schizophrenia.

As McMahon’s delusions intensified, his roommates realized something in his brain had gone horribly wrong. McMahon argued that the object of his obsession was in their house, and he began to suspect the roommates of a conspiracy. Eventually they recognized that he was suicidal and called his parents in Eugene, Oregon.

“My roommates told my parents that I was outside and they were afraid I was going to run in front of a car,” McMahon says. His parents called 911, and he was taken away in an ambulance.

McMahon says his first hallucination was on June 13, 2003, and he required hospitalization on July 8—less than 30 days later.

“I actually blacked out for a little over a week and I came to in a [second] hospital wearing different clothes. It was pretty confusing,” recalls McMahon.

Staying in the hospital gave McMahon time to ponder his situation, and he ultimately understood that his belief in his delusions was causing his problems. “At that moment I let go of all of those beliefs, which was really, really painful,” he says. “It was quite demoralizing.”

In addition to feeling hoodwinked by the voices, McMahon felt a sense of loss at relinquishing the beliefs in which he had invested so much energy. Slowly, he learned how to cope with schizophrenia, and he built a new life in Eugene full of music, art, and friends.

The rapid onset  and the type of symptoms that McMahon experienced are both indicators of a greater chance of recovery. Paranoid schizophrenia is usually treated by first administering antipsychotic drugs to reduce symptoms of hallucinations and delusions. The drugs take one to two weeks to have a significant effect. When good health care is available, the introduction of pharmaceuticals is followed by counseling. Both of these treatments were available to McMahon.

McMahon has a repertoire of humorous stories from his two cumulative months in Seattle and Eugene psych wards, and he tells them all with a penetrating chuckle and slang from the hip-hop music he loves. There’s a story about the hospital staff realizing he’d take his medicine if a pretty nurse handed it to him, and another in which a fellow patient yells at him for moving too much.

“I use humor to cope because it doesn’t hurt me like it did when I first got out,” says McMahon. “The experiences and the things that the voices said haunted me for a while. Stories about when I was in the psych ward are actually pretty funny.”

McMahon describes coming to terms with his schizophrenia philosophically.

“Psychosis is this interesting paradox. When you’re crazy, the reason you’re crazy is because you don’t think you’re crazy. I realized I was in the Johnson Unit because I was crazy. That was the exact moment that I became sane again,” says McMahon. He chuckles again. “It’s kind of Zen.”

However, recovery from schizophrenia is controversial, and study groups are working on revisions to the official definition of what recovery from schizophrenia means. Many patients have symptoms to a certain degree for the rest of their lives, and some advocates believe that the current definition, which requires a return to pre-schizophrenia functioning, is harsh and discouraging.

“I still hear stuff today sometimes,” says McMahon. “If I get lots of sleep and am not letting myself get stressed out I don’t hear things as much, but a lot of it’s just not reacting to it too strongly.”

On a typical day in recovery, McMahon works on his music, hangs out with friends, and drinks a lot of coffee. Lately, McMahon and his 21-year-old brother have been engrossed in kung fu movies. He creates gifts on his design software, like an “official” Church of Sk8in membership card he presented to his sister, a member of the roller derby club.

“To me, recovery means not letting that stuff affect me,” McMahon explains. “The actual symptoms don’t really bother me that much. Usually today, I’ll just hear music at night.”

Keeping a low stress level keeps McMahon from doing some of the things he would like to, such as finding a job. Still, he looks forward to being ready, probably after he’s finished adjusting the dosage of his medications. “Part of me is kind of afraid because it seems like a bit of a risk, but at the same time I don’t want to live off of Social Security my whole life,” says McMahon. “It’s a hard decision to make.”

“I can’t expect the same things from life as other people,” McMahon says. He has dated, but he doesn’t like communication, so intimate relationships are difficult. Instead, it’s his relationships with his friends that calm his mind and still his thoughts. While he doesn’t usually talk about his schizophrenia, the presence of friends is soothing. McMahon’s rule of thumb is, “When I show up around people I like and I’m excited to see, I feel good.”

As he recalls a recent hallucination, McMahon laughs. “This one night I was lying on my left side, so my left ear was on the pillow, and I was hearing Metallica. I rolled over and there was a chick singing this R&B song, so I thought, ‘This is cool, I’ll go to sleep to this.’”