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Column   |    
Personal Accounts: Who Are "They"?
Molly Wilson
Psychiatric Services 2007; doi: 10.1176/appi.ps.58.6.749
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Ms. Wilson, who is writing under a pseudonym, lives in Australia. Send correspondence to her in care of Psychiatric Services, 1000 Wilson Blvd., Suite 1825, Arlington, VA 22209. Jeffrey L. Geller, M.D., M.P.H., is editor of this column.

Due to a combination of stress and taking drugs, I slipped into psychosis, experiencing insanity and all symptoms relating to psychosis: paranoia, rapid and confused thoughts, inability to distinguish between fantasy and reality, being emotional, and suffering from sleep deprivation. All of these symptoms had such a profound effect on me that they compounded my thoughts of suicide, resulting in a suicide attempt, which luckily failed.

My psychosis was like a muddled-up novel. The story in my mind during my psychosis seemed so big and complex. I didn't know where to begin or how to articulate my thoughts, which were racing. But now I am well and can articulate my experience with psychosis.

One of the main symptoms was paranoia. After using drugs, my feelings of betrayal and thoughts of people plotting against me intensified. My paranoid thoughts were associated with people I cared deeply about and who had been a part of my life for years.

When I began slipping into psychosis, the process was gradual. Then it snowballed all at once. At the beginning, paranoid thoughts slipped in and out of my mind for a duration of weeks or months. As time went on, the paranoid thoughts grew bigger and bigger, and I became convinced that people were out to destroy me—they were part of a big game to destroy me. The longer I went without help, the more suspicious I became that the people around me were involved in this game.

On one occasion my family took me out to dinner for my birthday. Our table was in the middle of the restaurant. I believed all who were in the restaurant were spies and detectives, each keeping an eye on me, and I thought my family members were in on it. My family was talking and laughing amongst themselves while I thought they were all laughing at me. I stormed out and caught a taxi home.

On another occasion I was in a bookstore, thinking that all the customers in the bookstore were on a stakeout and watching my every move. I felt everyone kept watching me. Mind you, when out in public, people do glance at each other unconsciously, but I thought they were spying on me. Being paranoid, I was suspicious of everything. Feeling everyone looking at me as I circulated through the bookstore, I felt that my insides were caving in. Paranoia consumed me, and I could no longer think rationally.

Thinking that people were after me (not only strangers but also family and friends) often occurred while I was sitting in a crowd of familiar people. I thought they all had it in for me. I sometimes felt like making a huge outburst and accusing people of spying or playing a game on me and telling them I knew about the game they were playing against me.

I thought that people could read my thoughts and that everyone knew what was ticking in my mind. This, of course, made the game they were playing easy for them! I got to the stage where I would keep my head down and look at the ground when I walked along the street because my thoughts of people looking at me were just too strong.

Everyone is capable of thinking about situations that are absurd and would never arise. I believed all of my thoughts, however, and I would think, "These thoughts are reality." I couldn't distinguish between the two, reality and fantasy. Before my psychosis I had read a book about a girl who was gang-raped and brutally murdered. During my psychosis, I had persistent thoughts that this was going to happen to me. I had an empty feeling inside, thinking that my own rape and murder were inevitable and that I couldn't change this fate.

My thoughts didn't always make sense. For example, I thought people were out to destroy members of my family. Here are some additional examples: my parents went out one night, which led me to think a bomb had been planted in their car and that I was never to see them again. I thought that my brother's unborn child wasn't his, a "trick" I had mentioned to my brother on numerous occasions during the pregnancy. Also, I thought my partner at the time was spying on me to gain information to become close to me so I would open up and confide in him—but really I "knew" he would betray me. I thought that when my partner and I both left our flat he wouldn't lock my apartment door so that he could return later and plant cameras and microphones throughout. In another example, I was convinced that the father of my son was going to set up a conspiracy by faking a car accident and their deaths in order to kidnap and vanish with my son—this belief absolutely devastated me.

Communications were totally confused. I thought conversations were all about me disguised only by different names people used. So if people hated someone or thought someone wasn't nice, they were really talking about me. I believed that the radio in my car was tapped and that the announcers were talking about me. I also thought movies were encoded to send a message about what they thought of me. In conversations about others, I would carefully defend everyone being discussed because I thought people were plotting to see my response. I lost my opinions. I forgot who I was and what I believed in. I thought I was in a terrible game, a game where I was the victim and everyone else were players.

I began to think I was a bad person. I lost who I was. My brain was racing a million miles per hour. I would telephone friends to see if they were still my friends; I needed constant reassurance. Receiving reassurance from family and friends would help for a little while, but then the thoughts would creep back and I would be back at square one.

My concentration and interest in doing things decreased in all aspects of my life; motivation declined. I became very emotional. I had feelings of hurt, anger, frustration, and disbelief. I became immensely frustrated—I had this huge story, and people wouldn't believe me. I just wanted to scream.

I cried, cried, and cried. I kept apologizing to people for all the things I thought I had done. I kept thinking I was a bad person. I felt as though I was in a bubble, all alone. Anxiety levels were rapidly growing.

Sleep deprivation was another symptom that I experienced. My mind didn't stop with the rapid and confused thoughts. I would find sleeping difficult. Once I slipped into psychosis and was drowning in abnormal thoughts, falling to sleep did not come easily. If I wakened during a night's sleep, my thoughts would continue from when I was previously awake, and my mind could not rest or relax in this state of psychosis.

One particular night my mind wouldn't allow myself to sleep. I walked around my flat on guard, spying through the windows, looking out at the night's shadows, and thinking people were out there spying on me. All of this triggered further anxiety. I felt alone, which brought on feelings of sadness and hollowness.

I was literally insane. I wanted to harm myself before anyone else could harm me, so I attempted suicide. Before attempting suicide, I drove up to the train tracks to jump in front of a train, but a train had just passed. I couldn't wait, so while driving along a freeway I was thinking, "How can I kill myself? Jump off the highway bridge! Drive my car into a brick wall!" The next day I heard on the radio in my car "jump off the highway bridge." I knew then I was insane. That night I lay in bed thinking how to kill myself. I thought of hanging myself. At the time I wished I owned a gun and could point the gun at my head and bang, over, dead! I went and took a sharp knife from the drawer and slashed my wrists. I thought that night was my last. I would be free from people wanting to hurt me and free from insanity. So I went to sleep, but I awoke. My attempt at suicide had failed. I felt animosity toward everyone who had touched my life in some way. My realization: I thought that I had been betrayed by the world.

I could go on forever about what was going on in my head. To think I thought that all of these things were going to be inflicted on me. I hated to imagine. Now writing about the experience in words all seems so surreal, just like a fictional story. Well it is hard to believe, now being sane after something so crazy and insane.

Education helped me to accept my illness and also to know that psychosis is treatable. Through treatment and taking medication to control the chemical imbalance in my brain, the "theys" who were out to get me are no longer there. I am currently studying at university to become a primary teacher. My psychosis is a chapter in my life that slowed me down for a year but has not prevented me from pursuing and accomplishing my dreams.

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