One of the more difficult things to understand about my husband Steve’s mental illness is his having a psychosis.
Steve has schizoaffective disorder, which involves severe mood swings and some of the symptoms associated with schizophrenia, like hallucinations and delusional or disorganized thinking. I understand mood swings; my own mood fluctuates from day to day. But delusions? Disorganized thinking? It took years to wrap my mind around these concepts.
Although Steve experienced mild hallucination—he occasionally saw the ceiling move or heard music that wasn’t there—he did have a significant problems thinking logically about some things. This made me wonder: How are thoughts formed? And what/who controls how we think?
Those questions are beyond my ability to answer, but living with Steve’s psychosis gave me some insight into how brain chemistry affects thinking.
Steve’s impairment centered around the organization he once worked for, SAE. He’d quit his job at this engineering society under less-than-ideal circumstances, and several years after leaving became obsessed with concerns about the society. Initially it was a small issue, about a tree that SAE failed to plant in memory of a deceased colleague. But it mushroomed into bigger ones, like the direction the society was moving under the executive director, whom Steve wanted removed from office.
Steve’s psychosis didn’t happen overnight; it emerged slowly over several years. Up to then—he was in his early 40s—he’d been a loving husband and a good father to our three young children. After the onset of psychosis, though, he became consumed with thoughts about SAE, willing to abandon all, including us, in an effort to “fix” an engineering society he’d been a member of since college.
Only after he was prescribed an anti-psychotic drug—which acts on brain chemistry—did his thinking about SAE modulate, allowing him to move on with his life.
With medication, Steve’s psychosis lay mostly dormant for two decades. It re-surfaced when he first read Rambler, my memoir about our family’s experience with his illness. Steve had always been an ardent supporter of my sharing our story, but hadn’t read the manuscript until it was almost finished.
We agreed that because Rambler was such a personal story it would be better for him to read it one chapter at a time, giving us a chance to talk about what he’d read before moving on to the next chapter. The arrangement worked well until he got to the chapter about SAE.
Steve likes to read early in the morning, before I get up, so I placed the SAE chapter on his favorite chair before going to bed. When I awoke, he wasn’t in his chair, as usual, but sitting at the kitchen table, the printed pages scattered around him. Also on the table were a stapler, scissors, several pencils, and a tape dispenser.
Steve was digging deep into the chapter with an intensity that echoed his earlier obsession with SAE. He’d written copious notes around the edge of the pages and rearranged parts of the chapter by cutting out sections and stapling them elsewhere.
Seeing this, I asked him to stop, which he did, for he understands the grip SAE once had on him. Through the acute stage of Steve’s illness he saw a therapist, Marci, who helped him understand and work through the myriad changes brought on by his illness. Even though he hadn’t seen Marci in years, he agreed it was best to meet with her as he worked his way through Rambler: A Family Pushes Through the Fog of Mental Illness, especially his emotional response to what he read.
This incident didn’t cause Steve to be taken over by delusional thoughts, as he’d once been, for he mostly understands the nature of his illness. It did, however, help both of us better understand the tenacity of chronic psychosis.
I share this as a way of saying that mental illnesses are complex and confusing disorders. While I still don’t grasp the clinical, diagnostic nature of these illnesses, I’ve learned a great deal living with Steve’s disorder.
