AdvanceAcclaimfor Me, Myself, and Them ‘‘LikeaSeaWorldunderwaterview,Me,Myself,andThemprovidesarivetingpeek intotheworldofschizophreniaforparentslikemewhoyearnforunderstanding. Foryoungpeoplewithschizophrenia,likeourson,thebookorientsafrightening illness.Forbothfamiliesandpersonswithmentalillness,thisbookislacedwith hope,somethinginshortsupplyinmostotherbooks.’’ —MindyGreiling,MinnesotaStateRepresentativeandExecutiveBoardMember, NationalAllianceonMentalIllness ‘‘Thefirsthandaccountisrealistic.’’ —JimGreiling,diagnosedwithschizophreniaatage21,now29yearsold ‘‘This beautifully told personal story provides an innovative platform for solid informationaboutschizophreniaanditstreatment.Highlyinformativetopersons strugglingwiththeonsetofpsychosis,andtofamilies,friends,andmentalhealth workerswhostruggletounderstandandhelp.’’ —WilliamT.CarpenterJr.,M.D.,ProfessorofPsychiatry andPharmacology,UniversityofMarylandSchoolofMedicine ‘‘The authors provide a first rate resource for anyone whose life is touched by schizophrenia. Through solid, easy to understand language, the manuscript pro- videsusefulguidanceforotherscopingwiththisdisease.Highlyrecommended.’’ —MingTsuang,M.D.,Ph.D.,DepartmentofPsychiatry, UniversityofCalifornia,SanDiego ‘‘Me,Myself,andThem:AFirsthandAccountofOneYoungPerson’sExperiencewith SchizophreniaisastraightforwardandmarvelouslylucidretellingofKurtSnyder’s battlewithhisdemons.Notonlydoesitshowustheexperienceofpsychosis,italso explains, in jargon-free language, what each element of that experience means. Compellingandeminentlyreadable,abooklikethisoughttoberequiredreading for allhigh school andcollege students, demystifying asit does an illness all too longshroudedinmisunderstanding,confusionandfear.’’ —PamelaSpiroWagner,authorofDividedMinds:TwinSisters andTheirJourneyThroughSchizophrenia ‘‘Istronglyrecommendthisbooktopatients,families,clinicians, andresearchers interestedinafirsthandaccountofhowschizophreniachangesthewaytheworld looks,feels,andbehaves.Itisverymovingandveryinformative.Fromcompelling descriptionsofchangesinmood,cognition,andperceptiontoexplanationsabout how the brain is affected and how drugs work, this brief but detailed personal statementandreviewofthestateofthefieldisinvaluable.’’ —DanielR.Weinberger,M.D.,Director,Genes,Cognition andPsychosisProgramIRP,NIMH,NIH The Annenberg FoundationTrust at Sunnylands’ AdolescentMental Health Initiative PatrickE. Jamieson,Ph.D.,series editor Otherbooksintheseries Foryoungpeople MindRace:AFirsthandAccountofOneTeenager’sExperience WithBipolarDisorder PatrickE.Jamieson,Ph.D.,withMoiraA.Rynn,M.D.(2006) MonochromeDays:AFirsthandAccountofOneTeenager’sExperience WithDepression CaitIrwin,withDwightL.Evans,M.D.,andLindaWasmerAndrews(2007) WhatYouMustThinkofMe:AFirsthandAccountofOneTeenager’sExperience WithSocialAnxietyDisorder EmilyFord,withMichaelLiebowitz,M.D.,andLindaWasmerAndrews(2007) NexttoNothing:AFirsthandAccountofOneTeenager’sExperience WithanEatingDisorder CarrieArnold,withB.TimothyWalsh,M.D.(2007) ChasingtheHigh:AFirsthandAccountofOneYoungPerson’sExperience WithSubstanceAbuse KyleKeegan,withHowardB.Moss,M.D.(forthcoming,2008) TheThoughtThatCounts:AFirsthandAccountofOneTeenager’sExperience WithObsessive-CompulsiveDisorder JaredDouglasKant,withMartinFranklin,Ph.D.,andLindaWasmerAndrews (forthcoming,2008) EightStoriesUp:AnAdolescentChoosesHopeOverSuicide DeQuincyA.Lezine,Ph.D.,withDavidBrent,M.D.(forthcoming,2008) Forparentsandotheradults IfYourAdolescentHasDepressionorBipolarDisorder DwightL.Evans,M.D.,andLindaWasmerAndrews(2005) IfYourAdolescentHasanEatingDisorder B.TimothyWalsh,M.D.,andV.L.Cameron(2005) IfYourAdolescentHasanAnxietyDisorder EdnaB.Foa,Ph.D.,andLindaWasmerAndrews(2006) IfYourAdolescentHasSchizophrenia RaquelE.Gur,M.D.,Ph.D.,andAnnBradenJohnson,Ph.D.(2006) Me, Myself, and Them A Firsthand Account of One Young Person’s Experience With Schizophrenia Kurt Snyder withRaquelE.Gur,M.D.,Ph.D.,andLindaWasmerAndrews The Annenberg FoundationTrust atSunnylands’ AdolescentMentalHealth Initiative 1 2007 1 OxfordUniversityPress,Inc.,publishesworksthatfurther OxfordUniversity’sobjectiveofexcellence inresearch,scholarship,andeducation. TheAnnenbergFoundationTrustatSunnylands TheAnnenbergPublicPolicyCenteroftheUniversityofPennsylvania OxfordUniversityPress Oxford NewYork Auckland CapeTown DaresSalaam HongKong Karachi KualaLumpur Madrid Melbourne MexicoCity Nairobi NewDelhi Shanghai Taipei Toronto Withofficesin Argentina Austria Brazil Chile CzechRepublic France Greece Guatemala Hungary Italy Japan Poland Portugal Singapore SouthKorea Switzerland Thailand Turkey Ukraine Vietnam Copyright#2007byOxfordUniversityPress,Inc. PublishedbyOxfordUniversityPress,Inc. 198MadisonAvenue,NewYork,NewYork10016 www.oup.com OxfordisaregisteredtrademarkofOxfordUniversityPress Allrightsreserved.Nopartofthispublicationmaybereproduced, storedinaretrievalsystem,ortransmitted,inanyformorbyanymeans, electronic,mechanical,photocopying,recording,orotherwise, withoutthepriorpermissionofOxfordUniversityPress. LibraryofCongressCataloging-in-PublicationData Snyder,Kurt. Me,myself,andthem:afirsthandaccountofoneyoungperson’sexperiencewith schizophrenia/byKurtSnyderwithRaquelE.Gur,andLindaWasmerAndrews. p.cm.—(Adolescentmentalhealthinitiative) ‘‘TheAnnenbergFoundationTrustatSunnylands,theAnnenbergPublicPolicyCenter.’’ Includesbibliographicalreferencesandindex. ISBN978-0-19-531123-5;978-0-19-531122-8(pbk) 1. Snyder,Kurt—Mentalhealth. 2. Schizophrenics—UnitedStates—Biography. 3. Schizophreniainadolescence—UnitedStates. I. Gur,RaquelE. II. Andrews,Linda Wasmer. III. Title. RC514.S565A32007 616.89'80092–dc22 2007016619 9 8 7 6 5 4 3 2 1 PrintedintheUnitedStatesofAmerica onacid-freepaper Contents Foreword ix Preface xiii One A Fragmented Mind: Overview of Schizophrenia 1 My Story 1 Delusions ofgrandeur 1 Theearly days 4 TheBig Picture 8 So what isschizophrenia? 9 Whogets schizophrenia? 10 Where does schizophrenia come from? 11 What are the early warning signs? 16 Two First Encounters With Them: Symptoms and Paranoia 19 My Story 19 A change ofplan 20 Being watched 21 A newopportunity 23 An unanswered message 26 vi Contents Toomany coincidences 28 Uncertain assumptions 34 Animaginationrun wild 37 TheBigPicture 40 What are positive and negativesymptomsofschizophrenia? 41 Howimportant arecognitive symptoms ofschizophrenia? 47 Are people with schizophrenia aware ofhow sick they are? 48 What are the differenttypesofschizophrenia? 48 Three In the Grip of Them: Losing Touch With Reality 53 My Story 53 Getting away 53 Glasgow, Montana 56 Intrusion 59 Lockdown 63 Returninghome 65 TheBigPicture 67 Howdoes schizophreniaaffect everyday life? 68 Whenand why ishospitalization helpful? 71 What are the ins and outs ofinpatientcare? 74 Where can youget help outsidethe hospital? 77 Four Naming and Facing the Enemy: Diagnosis and Treatment 79 My Story 79 Thedelusions intensify 80 Back tothe hospital 81 Back tothe outsideworld 82 Giving THEMa name 83 TheBigPicture 84 Howisschizophreniadiagnosed? 84 What conditions often coexist with schizophrenia? 86 Contents vii Why isprofessional treatment soimportant? 89 What medicationsare used totreatschizophrenia? 90 How does psychological and behavioraltherapy help? 96 What isthe outlook for the future? 100 Five Beating the Enemy: Recovery from Schizophrenia 103 My Story 103 Accepting schizophrenia 105 A newdirection 106 TheBig Picture 109 What are psychosocialrehabilitation programs? 110 What types oftraining and supportare available? 111 How can you cope with schizophrenia at school? 115 How can you deal with schizophrenia at work? 119 What are options for living onyour own? 121 What are tips for handling social situations? 126 What are tips for coping with stress and change? 130 Six Putting the Pieces Back Together: My Life Today 133 Epilogue toMy Story 133 Frequently Asked Questions 137 Glossary 143 Resources 149 Bibliography 157 Index 159 This page intentionally left blank Foreword The Adolescent Mental Health Initiative (AMHI) was created by The Annenberg Foundation Trust at Sunny- lands to share with mental health professionals, parents, and adolescents the advances in treatment and prevention now availabletoadolescents withmentalhealthdisorders. TheIni- tiative was made possible by the generosity and vision of Ambassadors Walterand Leonore Annenberg, andtheproject wasadministeredthroughtheAnnenbergPublicPolicyCenter of the University of Pennsylvania in partnership with Oxford University Press. The Initiative began in 2003 with the convening, in Phi- ladelphiaandNewYork,ofsevenscholarlycommissionsmade up of over 150 leading psychiatrists and psychologists from around the country. Chaired by Drs. Edna B. Foa, Dwight L. Evans, B. Timothy Walsh, Martin E. P. Seligman, Raquel E. Gur, Charles P. O’Brien, and Herbert Hendin, these com- missions were tasked with assessing the state of scientific re- search on the prevalent mental disorders whose onset occurs predominantlybetweentheagesof10and22.Theircollective ix