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As I mark my 20-year anniversary of becoming homeless in the Los Angeles area (March 3, 2003) and my sixteenth anniversary of beginning treatment (March 3, 2007) I look back and explore the choices I made at that time. The choice to drop out of school, where I had once thrived and had been successful and happy. The choice to break off all ties with immediate family, extended family, and friends. The choice to sleep outside, even though my parents and many friends would have welcomed me into their homes. The choice to search for food in garbage cans rather than to access a food bank.
But when I look back, I realize that perhaps these were not really choices. Any person in their right mind would never have decided to live as a dirty homeless person when free help was readily available. The chaos in my mind led to my pathetic homeless existence. Like so many others, I was driven to change my life by my schizophrenia.
The choice to be homeless
As I continue my work as a mental health advocate, I am amazed at how many young people I encounter with schizophrenia choose to be homeless, just as I did. The mother of a promising young student who completed a bachelor’s degree in economics told me about her son who chose to spend every night in the university library, post-graduation, for years. It seemed he was not bothering anyone or a danger to himself or others, and he slipped through the cracks, perpetuating a life of untreated schizophrenia.
I can think of several others who chose homelessness including a physics Ph.D. candidate, and a young woman who planned to sell her home, thinking she could change the world if she became homeless, which is similar to my personal story. There are countless others.
I do not know why people with schizophrenia are so attracted to the homeless life, but perhaps it is an attempt to escape from regular life with all of its disappointments and stressors.
The choice to obey the voices
Years back, prior to my decision to disclose my schizophrenia, and while I was in college, I attended a social gathering where the topic of hearing voices came up. A young law student said that people who hear voices are “culpable” for their behavior because they hear a voice and then can choose to follow it or not. However, this has not been my experience.
If I had been able to simply choose not to scream when the voices told me to or walk in strange zigzag patterns at the command of the voices, I wonder if I would have ever been picked up and taken for psychiatric evaluation. The reason I was finally apprehended by police was because I was screaming back at the voices and behaving in strange ways. The reason I was finally diagnosed with schizophrenia was because of my command hallucinations, which I could not ignore.
Recently, a mom contacted me whose son was having command hallucinations telling him to set himself on fire. The young man was aware of what it meant to set himself on fire and the pain it would cause. However, his voices screamed at him relentlessly until he gave up, lit a match, and burned his clothing.
Many young people with psychosis find themselves in the criminal justice system for crimes they would have never committed had it not been for their psychosis. One of my friends with schizophrenia who I have enjoyed knowing for many years tried to steal a truck during an acute psychotic episode. Fortunately, when she was taken to jail, she began treatment for her psychosis, which led to finding the right medication and eventually full recovery.
But many people who commit crimes while psychotic are not that fortunate. Many are unmedicated in jails or prisons or forced into solitary confinement after their symptoms spiral out of control.
There should be more compassion for desperate people who do things they would never do in their right mind. These people belong in hospitals, not in prisons.
The choice to leave work or drop out of school
In 2002, at the time of my first psychotic episode, I remember taking my first molecular biology exam of the semester. I thought I aced it! I had aced exams before. However, when I received the grades exam, I had scored an F. I had written gibberish for all the answers. My mind was like a thick cloud where I could think of nothing but my recent trip to Africa. I told myself that dropping out was my choice. But in reality, there was no decision to make, with my broken mind.
New choices in recovery
When I began antipsychotic medication for the first time, suddenly, I couldn’t remember the reason why I was homeless, or out of touch with family and friends. Suddenly, I found myself able to ignore the commands of the voices in my mind.
Remarkably, when I chose to discontinue medication following my release from the hospital, my desire to live a homeless life returned, and when I resumed my medication, the desire to live outside, homeless, went away again.
For the past 16 years, I have taken antipsychotics, which have restored my ability to make logical and reasonable choices. Today, I live in my own apartment, hold a college degree, and work hard every day. Life is fulfilling and joyful.
It is important to not blame the mentally ill for making ludicrous and unsafe choices. Many, like me years ago, simply cannot think logically anymore, due to a psychiatric illness, and are plagued by relentless voices in their mind.
When I spoke with the woman who planned to sell her house to become homeless, I told her to get into treatment first, which would most likely include medication, and then make the decision.
I continue to be amazed at how powerful antipsychotic medication and treatment can be, enabling even someone in the depth of psychosis to find a path toward a normal and meaningful life.
