This article includes descriptions of self-harm. If you or someone you know is hurting themselves, you can contact Mind on 0300 123 3393.
This article originally appeared on VICE Germany.
Imagine hearing a voice that tells you to pull a plastic bag over your head and hold on tight. For Laura*, that voice came from inside her own head – and it wouldn’t stop until she did what it said.
Laura has paranoid schizophrenia, a mental illness characterised by delusions and hallucinations. She first experienced these symptoms when she was 18, after a night out drinking with a friend; at first, she was confused by the voices, which kept growing louder and louder.
"I thought there were people in the room," recalls the now 21-year-old. "I wasn't really there, but I wasn't really gone either.” When the voices suddenly told her to end her own life, she tried to suffocate herself with a plastic bag. But shortly before passing out, she ripped it open and called some friends, who immediately took her to a hospital.
In the months that followed, Laura had over 20 psychotic episodes. After going to therapy and fine-tuning her medication, she’s back on her feet and working as a trainee in a new job. Like other mental illnesses, paranoid schizophrenia is often misrepresented in popular culture. I asked Laura what it’s like to live with a condition that distorts your sense of self and reality.
VICE: How many people live inside you?
Laura: The idea that schizophrenic people have multiple personalities is complete bullshit. I’m still me – I just have five companions who are always there. Usually, you tend to distance yourself from your own body. I used to cut my thigh deeply with a box knife out of curiosity. I wanted to look at the different layers of fat and see what my veins looked like when they pumped blood out of my body.
What do the voices in your head say?
I hear five voices, and they're all strangers. There’s a small child's voice, about five years old. She defends me when the others insult me. There’s a man's voice, he's the submissive. And then there are three other female voices. One of them is the most dominant and abusive, the other two are followers.
Psychoses are assessed with a traffic light system. Green is when we’re just talking. In the yellow phase, they insult me and say I’m ugly or shit. Red is when they say, "Now, take a cigarette and put it out on the back of your hand."
Are you afraid of yourself?
I once had myself committed because I was afraid I wouldn't survive my next psychosis. Still, I was never considered to be acutely suicidal. I tried to kill myself a few times while I was psychotic, but only half-heartedly. Once, I mixed a drug cocktail I knew was not fatal. In those moments, I know what I’m doing is not good, but it’s the only way I can silence the voices if I don't have my medication with me.
So far, I've always looked for help when the situation has become serious. When my mother found out how many times I’ve tried to kill myself, she burst into tears. If you have depression like me, you always think nobody would miss you. But I’ll never forget her reaction. I couldn’t do it to her.
When do you tell someone you’re dating that you’re schizophrenic?
Outside of work, I talk about it openly. Still, I wouldn’t say it right away. Usually I tell them I have depression first. If someone changes the subject, I know it won't work.
How hard is it to be in a relationship with you?
I don't think it's that hard for my boyfriend. I’m one of the more communicative people you'll meet. He’s my first point of contact, and notices pretty quickly when I show early signs of a psychotic episode. I suddenly speak in a very childlike voice or seem apathetic.
Are your friends afraid of you?
No, they know where my emergency medication is and never to leave me alone [during a psychosis]. They also know not to whisper around me, so I don't think I'm hearing something others can't. I totally reject people when they tell me the voices aren’t real during a psychosis. For me, they are completely real in the moment. Plus, I'm already far too deep into it for common sense to work.
What was your worst hallucination?
I often used to feel ants crawling all over me. That was really scary, because I had a big fear of ants. Sometimes, when an ant crawls on my leg, I still don't know whether it’s real.
Are you unpredictable?
No, I can still communicate with the outside world when I'm psychotic. I don't close myself off completely. If the voices tell me to hurt myself, I can tell that to a friend in the moment. But the voices come with a lot of emotions – when they tell me I suck, it's worse than when a real person says it.
What's the worst thing you've done during an acute psychosis?
The incident with the plastic bag. I didn't want to die, but the voices told me to. I didn't have the strength to defend myself. I thought that, if I refused, something worse than death would happen. Fortunately, I then had a moment of clarity.
How afraid are you of another psychosis?
Really afraid. Currently, I "only" have depression, but it can get worse at any time. Psychoses can be triggered by stress, but also by extreme happiness. I had an episode after passing my driver's license. In my job, you have to be able to work under pressure. I’m scared I’ll eventually realise I can’t take it.
If I had another breakdown, I’d have to take time off work and have my medication readjusted. I’d have to let my boss know. Most people don't understand you can be healthy and sick at the same time. My psychiatrist says I’m fit for work, but I know my colleagues would be walking on eggshells around me [if they knew].
My biggest fear is that my medication will eventually no longer work and that there will be no alternative for me.