It's hard to imagine what it's like to lose your sanity, blissfully as you change from normal to mad, and then hope you can change back. For the better part of the century, psychiatric patients were relegated to the back wards and given crude and desperate treatments. That was the best medical science could offer. Severe mental illness, once thought to be caused by bad parents or evil spirits, is now viewed as the result of faulty genes, an illness within the brain itself. Because of a recent revolution in neuroscience, there are new biological treatments for the millions who are needy enough and brave enough to try them.
Yet despite all the advances, the struggle to find the way back from madness continues. Can you tell us what is it that's bothering you? I lost my mind. You lost your mind? How can we help you with that?
Give it back. I'm sorry, I can't. Give it back.
Give it back to you? I want a cup of coffee with dog food. That puts me in...
Why not? It's true! Dog food! That's what I'm a dog! I was born as a dog!
I wish you'd like my helmet all back. I'm not paranoid schizophrenia, I just know what I'm talking about. talking about? It's not my fault.
I'm Jesus. Like I said yesterday, all I wanted them to embrace me is like I'm lost because people in here don't accept me and people out there don't accept me. It's like the only one accepts Todd is Todd.
I can see society, you know, and it's just like this. That's keeping me from them, you know? It's like I'm in a glass cage.
look it out at them and I can't I can't be out there with them This doctor thinks there's this voice in my head named Andrew, you know, that's telling me to do all these things, you know. It's like, she's supposedly my doctor, you know, and you see the big doctor-client trust we have. If he goes to the hospital, I'm going to be the doctor. back out in the streets untreated and the wrong medicines that he can he's in danger of hurting somebody pretty badly whereas if in the interesting thing is when he did take medication that he was he was in much better shape there's a state law I can refuse medications medication medication she basically wants to get me on four different drugs and uh i don't want that to happen you know what it's like to take helenol do you know what it's like to take some of the other psychiatric drugs they give you turns into a zombie you sleep 14 hours a day you can't sit down in one spot you can't sit down in one spot on when i was on a hell and all here For 15 minutes at a time, you get so jittery, your hands clamp up.
Give Todd a break. I'll be out of Massachusetts hair. Just let me out of those doors.
I'm going back to Fort Lauderdale, Florida to enjoy paradise like everybody else that lives down there. You know, all those rich people that got all those boats, those yachts, and they got names for their yachts. You know?
You're not going to have that town if you go? I won't have a yacht, but I'll have myself, and I'll be free, and that's what I'll have. Join the spider right here, baby.
Cowboy Paul. Thank you so much and have a great week. Sometimes at work I do hear voices and actually the people having a conversation make the hallucination worse. I'm having a really good time.
I start confusing human voices with the voices of the psychoses. And I can't really... and the voices just start all blending together. Sometimes it's really difficult to tune them out, but I really, I just sort of bite my tongue and I just keep going.
What? I think that ought to be funny. Okay. Nice. That's very good.
Bye, Dad. Bye, Joseph. Bye. How about two years ago, I felt like somebody was watching me do my homework, and then I just started hearing these voices from the sky. I was in my dorm room for three days.
I didn't eat, I didn't sleep. And I went from being a really functional... outgoing student, I had a complete nervous breakdown.
I mean, I couldn't cross the street. I almost got killed by a Warner bus. I couldn't keep, eight hours would go by, it seemed like a minute.
I was just being like this trance in this little world, and you couldn't talk to me, and I couldn't hear anybody. I did my work. I turned my papers in on time. But I'd be alone in my solitude and I'd just be crying all the time. I got to the point where I was like, I can't live this way.
And I would swallow a box of sleeping pills. And then I'd change my mind and I'd make myself throw them up and... and I never told anybody, but I'd always get up the next day and I'd put on, I'd take a shower and comb my hair and turn in my Greek homework and nobody knew, you know, you know, nobody knew I was having problems.
Has there been a period of time where you've gone a week or more without voices? No, I hear them all the time. So it's a constant daily struggle for you.
What we're going to do is start clozaping today. Everything seems fine. your wide blood cell count is fine, which means that we can go ahead and start the clozapine. Okay. So the most important side effect is the risk of the medication lowering your wide blood cell count.
Right. That's why when you return to school. You'll have to get a blood test once a week, see the doctor and get your medication.
I just want to pull your sweater up. Naomi is someone who seems to have schizophrenia. Good. Clozapine is a new medication that we have found to be superior to all other antipsychotic medications.
So if there's any hope for Naomi to remain functional, Clozapine is it. Right now, like, I'm really sick, so... It's frightening.
You know, I hear voices, and the more stressed and worried I am, the harder they are to deal with. Because then the voices tend to be very negative. So that, like, the more I worry and the more I stress, the more negative they are, the more distracting they are.
I think it's just a downward cycle. There's nothing worse in this world than losing your sanity. I grew up with it.
I was used to seeing it. All I knew was insanity. My father has mild depression. My middle brother is also a manic depressive. And my mom is schizophrenic.
My mom was committed after I was born. She had shock treatments. She's been sick my whole life. I was used to it. I was used to her screening obscenities and talking to herself and carrying around knives.
And I could never understand why. I never understood, why don't you stop it? Why don't you stop it and be my mommy? Why are you saying all these irrational things I can't understand?
What frightens me the most is that, you know, that I end up like my mother. I want to leave my mark on the world. Not a big mark, just a little mark, you know. I want to be an English professor, so maybe like an old dusty book in a library somewhere that nobody reads.
A few classes, you know. And there's just certain things I just want to fill. And it's like frightening, sometimes I don't know if I can do it. Hi, I'm Kathy Mooney, one of the nurses here in the holding area. I'm going to take you in and get you ready for surgery, okay?
Okay. So come with me. Okay, I'm just going to have you remove your bathrobe, okay? And you can get right up onto this bed, and I'll cover you up with a blanket. This is the frame you're going to wear when we do the MR scan.
It's not too heavy, and we just put it right on your head like so. I have been a photographer all my life. About three years ago, I had to give it up due to my illness.
If you feel any sharp pain, you just let us know. We can put some more freezing. I have obsessive... compulsive disorder and you can't have OCD and be a happy person it just doesn't work that way just on the left side because you do things that you know are actually very stupid and you know better and you just can't stop it I can look at things and I don't believe what I see. And therefore I don't double check.
I check 10, 15, 20, 30 times the same thing. I check things because everything has to be perfect. I have to make sure my shoes are laced up exactly perfect.
I'll go into my closet and I gotta check to make sure that it's my coat. Well, nobody lives with me. Naturally, it's my coat. Uh, I wanna stay clean. A little is good, more is better.
So, the hotter the water, the cleaner my hands. The more soap I use, the cleaner my hands. And I would say, in a day, I use...
anywhere from a bar of soap to a bar and a half of soap. I could be back here anywhere from a minute to an hour doing the same thing. Sometimes I walk out and I will... decide to take my shoes off, come back in and repeat the whole thing again. Like I've lost all my confidence in the mechanics of the camera.
I would be checking everything so much that finally the dad or the groom would yell down to me, would you take your damn picture? When I was growing up, I was very shy and at a very young age, never wanted to get dirty. I knew something wasn't right, and it's reasons I have been divorced twice.
My girlfriend is the real reason I'm here today, kind of risking my life to have this operation. I'm pretty nervous now and I'm pretty scared. And a lot of things could go wrong that would be a thousand times worse than just washing my hands. Here you can see the selected target site in the cingulum. And the tip of our electrode will be inserted down to this point, and the lesion will be made in the anterior cingulum, just like so.
One on the right, one on the left. The cingulotomy is an operation on the brain. We actually destroy a small part of the brain.
That is hyperactive. Now, Glenn, this shouldn't hurt. You may feel some pressure, but it shouldn't hurt you at all, okay? In the past, surgery procedures that were done were crude. Not gonna...
That's not hurting you, right? Hear a sound and a vibration? The lobotomies that were performed in the 30s and 40s were done because there was no other effective treatment. But 5 to 10% of people died from the operation. It was a procedure.
that was almost indiscriminately applied....has further advantages in that it leaves no scar. It is performed through an operating field that is normally sterile, and the stiff tarsal plate forms an ideal reinforcement... There were tremendous side effects associated with the procedure.
There was cognitive impairment, seizures, memory disturbance, personality change. The cingulotomy is a very safe procedure. You're going to insert the probe. Can you wiggle your toes, Glenn, again? Good.
We're going to start the lesion. What is the temperature? It's 32 degrees. Okay, we're making the lesion.
Make the lesion. Temperature going up. How are you doing, Glenn?
Okay. You're okay? Yeah.
We're almost done now, alright? You've been, you've done very, very well. Everything's gone just fine. We're almost done.
We're just closing the skin. Get this frame off your head and put a little bandage on and get you onto a more comfortable bed. I got your neck. Got it.
Watch his nose. Okay, now get him a pillow. Get him a comfy pillow here. Great. Wiggle your fingers for us.
Great. You did very well. You can still play the piano. Still play the piano. Great.
Could you play it before? No. Glenn, everything went very nicely and you did very well.
Okay? Everything went very nicely. You did well.
Over the last two years, there's been a very serious depression. Then over the last six months, it's gotten increasingly worse. Physically, it gets to the point where all I can do is lay in bed all day.
And mentally and emotionally, it gets to the point where I'd rather be dead than living the way I am. It's not such an active feeling of death or of suicide, but it's just a feeling that nothing can be worse than that, and the only way to alleviate the pain is to be dead. I'm holding off a real attempt towards suicide because if I do try it again, I don't want it to be something that fails. I want it to be something that will be successful. So I won't have to go through the trouble or the misery of having to face everyone if it fails.
I'm a musician and I haven't been able to play. All I see is the thing that I've prepared to do. My whole life is just not going anywhere. The first time I ever played music, I guess, was when I was two. I used to crawl up and play the piano.
I started playing viola when I was nine. I went to Juilliard for my master's degree. I played with the Juilliard Orchestra in New York and in France, and I played with the Tanglewood Music Center Orchestra, the Boston Philharmonic Orchestra.
It's just the thing I've always wanted to do, and it's not going to be possible if I'm like this. It feels like this is my last hope for something that could completely make me well. Come on in, we're going to do the treatment in a couple of minutes. Okay.
Dr. Drop is going to inject two medications, short-acting sleeping medication and then a muscle relaxant. For you, it's going to be like taking a five-minute nap. Okay.
You'll be going to sleep in a few seconds. Okay, you're going to start to feel yourself getting a little sleepy now. Electroconvulsive therapy is simply the intentional induction of a grommel seizure under very controlled circumstances. For some reason the seizure normalizes brain chemistry through mechanisms that we really don't understand.
The treatment electrodes are going on. That's good. Now, if we didn't medicate the patient first, it would be a violent treatment. And it was when it was first invented. During the post-war era, the treatment was overused and sometimes indiscriminately used.
Patients frequently had bone fractures during this treatment before the use of muscle relaxants. In the past, BCT was done with a technique which caused a great deal of memory disturbance. And consequently, I think many people experience severe impairment of their memory and their intellect. It's a different treatment now, technically.
Here's the stimulus. 0.75 seconds. The stimulus duration. Good seizure, good generalization. That's the end of this unit.
You had your treatment. Well done. Okay. Probably feeling a little bit groggy right now. Alright, but that's from the medication.
I've been feeling very bad for about two years. And now I had my first ECT treatment two days ago. And now I feel miraculously better. And that isn't just an adverb to go with it.
It really is miraculous, I think. Just everything, I mean, the way I'm thinking, the way I feel, the way I look at everything and conceive and perceive everything is different now. Oh, I can't do this. I can't do this. It makes me sad that I can't play my viola.
But I don't know. I just don't know how I'm supposed to feel now. So it's been a while.
Yeah. Yeah, about almost three months really. Yeah.
The medication, what's it been like? I've had like a really hard time with it. It's just very hard for me to get up in the morning. I'm very sick in the morning and I'm still hearing voices. I took a harder schedule than I should have.
Like I really, I was fine. Like I went to school and I had the psychotic symptoms and stuff but my classes weren't i mean i learned a lot they were hard but they weren't as hard as this so i have to take it in complete or two and i'm a little behind but i mean i'm dealing with it like people need their solitude like i don't feel like i have a private private life or you know any sort of solitude at all okay okay so it was a really hard time yeah Are you still optimistic? I don't know.
I guess I should be, because I say part of it is psychological. Like, you have to want the medicine to work to work. So I guess I should be, but I am a little skeptical.
And I am a little like, this is like the fifth medicine I've been on. You know, and I want it to work, but at the same time, I sort of wonder if I'm going to have to live this way for the rest of my life. Hi, Naomi.
I just want to make sure you're clear on what's happening. You know, from what I've heard from your roommate. And also from your brother, Harry called me as well. I know that things apparently got out of control in the apartment. Apparently at this point we're going to have to try something different.
Unfortunately the closer rail just wasn't doing what we hoped it would. I know you don't want to talk, so I don't want to push you about that. Okay, but we will try to do whatever we can to make you comfortable. You know, if you have questions, please ask.
If you have questions about what's going on, please ask. We'll explain it to you. You know, and as we come up with a plan about what to do about the medication to try to control the symptoms, obviously we'll go over that and explain that with you also.
Is there anything you want to say or ask me? Okay. Okay, so I'm going to be going now. This is nice, isn't it? It's beautiful.
This is, they've got goldfish, turtles, minnows, guppies. This is paradise. Mead, this is medication, you know?
It makes me want to sing. Edelwein, Edelwein. Dance, may you bloom and grow, bloom and grow forever.
You might want to catch the front and see the eagle. The truth is, I get high without taking my medications. Anybody that's addicted to highs doesn't want to give it up.
Nobody wants to come down. I don't want to come down. I am still alive! I'd rather live with my disease than take these damn pills. I've struggled with this bastard disease my whole life.
What are you doing up there, Todd? Being me. It's like this big, huge rock that I have to carry.
You know? And I don't ask no one to help me carry this rock. I'll carry it my own self.
That's beauty! That's an eagle! Woo!
I don't have anybody telling me what to do. I don't have to do nothing. I do what Todd wants to do.
I control my life. Go guys! Supper time! I like these seagulls better than I do humans.
When he was younger, he would just kind of care for him like any other baby. He didn't start changing until he had to start nursery school at age four. And then he found it a little hard to adjust to other children.
He just became overwhelmed easily. He was a cute little guy. Real cute.
You know, real playful. He was extremely athletic. He was very active. Always wanted to travel.
Because he's kind of a restless boy. And then he was real, real good in sports in high school, and that he lived for. He did real well with that up until his sophomore year. He had a real bad race because he fell down.
He fell down at the state meet, and the coach thought he was on drugs. And, of course, it was totally devastating. And then he, all the kids, he wasn't voted captain the next year, and so he quit.
So it was very traumatic for him. We're a middle-class working family and you don't expect these things to happen to your children. You don't expect to have a child go out in the street and sleep and that's very hard. I donate plasma, I get social security, and I go to churches and I basically ask, you know?
How much do you get for donating plasma? Ten dollars, that's it. And you get codes like you wouldn't believe.
You get colds, you get sick, you feel drained. Sometimes you feel like you don't want to pass out, you know? But you need money, you know?
You need to survive, you know? And if they found out I was mentally ill, they'd cut me off just like that. Come follow me and I'll show you my home.
I live right behind the Greyhound bus station. That's my home. Come on. This is my patio.
This is my home. Home sweet home. It doesn't bother me.
Maybe it bothers my body. My body might break down, but my mind doesn't mind. You know what I mean?
What's that over there on the wall? That's... that's feces. Shit.
So I mark my territory. What does marks mean? You're not welcome.
They're already checking us out. We should go. Who's checking us out? The guy did.
Let's go. Does he know you're sleeping here? No. My freedom is the most meaningful thing of my life. I'm not going to give it up for nobody.
You don't understand that I'm at war. This bail, gentlemen. I'm at war.
And I'm winning. You see me locked in a nut ward? I am winning. Well, I came here from Seattle to follow up on my surgery, and I brought my girlfriend, Maureen, for company because I was nervous. Did you notice any improvement, any worsening?
in any way. When he is with me, he seems okay. I think the biggest disappointment in it for me is that in my Private life when Maureen's not around, I'm in my own apartment and whatever, is that I'm no different than I was. I'm no different.
I think I see an improvement. Well, when I first met Glenn, he could not shoot anymore. We now do weddings together. Before, he couldn't, he could not trust his F-stop. Clearly, the underlying illness has not been dramatically changed, although there are some modest, I guess you would agree, maybe modest improvements.
Having said that, there is a... percentage of people that will get better after a second and after a third procedure. The operation is exactly the same as the first one. The lesions we make on the first time are fairly small and the second procedure we simply enlarge that. What would you think about a second procedure?
Not right away because the first procedure was so painful that I still remember it so vividly. And also, it's too soon. It's easy for me to say, but it seems like to go this far and not pursue it to the end would seem kind of futile.
Okay, that's good right there. Lower your head down just a little bit. That's fine. When I first met Glenn, his hands were cracked and bleeding and bleeding all over the cameras. I'm going to bracket a couple.
Now they look much better. My fear is that he'll give up. That's it. I keep telling him, you know, you're not out to pasture yet. You can improve.
That's what I want. I just end up going back and forth to doctors for things just keep creeping up, and I get older every day, and pretty soon I'm thinking, you know, by the time I ever do get cured, I'll be so old I'll probably die within three days after I get cured. That's beautiful. Hold on a second.
You're the windsurfer. I don't know. I don't know what I'm doing with my life.
Right now I just want to get through college. Well, since I've been in the hospital, I slowly started getting better. I was really frightened and paranoid for a while.
I wouldn't talk to anybody. And they put me on Depakote and Risperidol, and I slowly started getting better. I started feeling better. And what's going on now in terms of your new voices? I don't hear any voices.
One, you don't hear any voices at all? I hear two, but they're not, they're not, they're pleasant. And they're very vague, and they're very far removed from me. I'm working at the Barnard Book Forum right now. It's right across the street from my school.
What is this, it's 295? 295, yes. I wish I could.
I was graduating. I feel like I've been left behind. But I'm going back to school, and I'll graduate eventually. Most of my symptoms have gone away. I don't really hear anything anymore, and I don't really feel sick anymore.
Like, I feel normal again. After how long? Three years.
Must be a great feeling. Yeah. It's a good feeling. I had to make an adjustment, though. The voices sort of kept me company.
I'd have these long philosophical conversations with them about life and God. I know that sounds really crazy, but it was interesting. Now I'm by myself all the time, so it's kind of weird. The silence is a little eerie sometimes. But I'm doing much better.
I think a combination of Adam and the medication has helped in my recovery. I can't get up. Help?
Adam's really supportive. He's very sweet. He's very caring. And he's just a very special person. You can't get me up.
I can't get up. Hold on, hold on. I've been seeing him for about five months, five and a half months. Did that hurt? It hurt my wrist.
He introduced himself when I was in the hospital. I was leaning against the wall. I was selectively mute.
I was a little paranoid and delusional. I was dressed in this horrible hospital gown. Just looked terrible. He came up to me and introduced himself, and he told me later because he thought I looked cute.
When I was in St. Louis, I would never imagine that six months later I'd have a very sweet boyfriend. I really thought my life was over when I was on that gurney. I really thought everything was...
I thought I was going to be committed for life. I thought I was going to be there forever. So I have to try to rebuild a new life for myself. That's all very hard starting over. And, um, you never know what happens.
I could get sick again. So I'm sure it's going to be a very rough road. Todd?
Yeah, hi. What happened? Um, nothing. They just said that I smashed some windows and harassing phone calls.
Nothing. Nothing too, I didn't kill nobody or nothing. so not so bad just it's just uh some people's word over mine how long have you been in for um pert near a month you've been in here for a month what's it like uh i it's it's violent it's it's very uh it's it's racial um a witness one dude get his ear taken off in a fight um i was laughing i was absolutely laughing you know it was like there it was like they were slow dancing and this dude's got the other dude by the ear i had to get a laugh out of it you know how does this compare to the state hospital you know we first filmed you about this is better than the lindemann center this is better than a Lindemann Center, okay?
It's better. Why? Don't have any roaches.
The food is about the same. You got more area to walk around in. You'd rather be here than be in the hospital?
Is that what you're saying? Exactly, exactly, because here I know that I can go to court, right? And they can give me not as much time as what the Lineman Center would have gave me, right?
Know what time they wanted to give me? Six fucking months, all right? In that state hospital?
In that state hospital, right? Six months. Are you taking your medicine?
Yeah, I'm taking my medicine. make a difference for you? That was then, this is now. You know, things change with the weather. In other words, do you need your lithium?
Yes, I do. I do need my lithium. That was a different person back then. I had a total different person. I'm a different person off my medication.
Let me ask you, do you think you belong here with convicts? Or do you think you belong in a hospital? Where do you belong?
I don't know. I don't know. I don't know. Number 118. I might want to double that also. Oh, just with him.
Okay, just before that. A little bit more. Um, let's see.
This is the first time that I've been playing since I've had ECT. So I'm very nervous and just very anxious about having to see all these people and get back into a situation where I'm actually playing. I mean, it's really just been so long that I don't see myself so much as a musician anymore.
I see myself more as a patient, actually. Measure nine. So it's um... It's something that used to feel so natural and so matter of fact now feels so foreign.
So... I'm just nervous. It's out of tune. No accent, no accent on the da-dum.
The figure is da-dum, not dum. Da-dum, ba-dum. I need to hear the F sharp, really nice big F sharp. Ba-ba-bum, ba-dum.
You're changing the string there? Yeah. Can you not do that?
I'm doing it on the G. Can you do it all on one string? Yeah.
Bar nine, one, two. Through the rehearsals over the last few days, it's just made me realize how much I want to do this again. I mean, I feel like it's possible, even now that the depression has kind of cleared out of my life.
For such a long time, it was there and it was so overpowering that I didn't think there was any way I was going to be able to escape it. I mean, it was just so consuming that I just didn't think any of this would be possible. I feel like it's possible to become a musician again. Hey, I'm Grace.
Hi, I'm Sarah. I'm Bailey. I'm Bailey.
Hey, baby. You are? I'm Bailey. Yeah, it's a great day.
I have some new room. Yeah. More TED? Yeah.
Fix some mess. Thanks. Thanks.
Beautiful