Hallucinations, voices characterize a young man's struggle with schizoaffective disorder

(October 3, 2005) - This story is based on a series of interviews conducted with the subject and his parents.

On a clear, autumn day during his senior year of high school, my brother, Clint, was seated in his English class working on an assignment when he heard a voice telling him he needed to kill a classmate.

He sat upright in his chair, not sure who was speaking to him. The voice spoke to him again. He needed to kill a classmate. Clint asked his teacher if he could be excused from class. He felt frightened. He needed space to think about what he was hearing, about what he was being asked to do.

He walked down the hall and opened the door to the boys bathroom. He could hear the voice as though it came from a man standing next to him in the bathroom, shouting in his ear. The voice grew louder and more intense. The words bounced sharply off the brown tiles on the floor and the walls, encasing him in a chamber of taunts and commands he had no desire to fulfill. When Clint failed to return to the classroom, his teacher went looking for him. He wasn't hard to find. She could hear him yelling. When she pushed open the door to the bathroom, she found Clint in the corner, seated on the tile floor, huddled against the wall, screaming, "I won't do it! I won't do it!"

When Clint was discovered by his teacher, my parents and I learned for the first time that Clint was hearing voices. But for Clint, this was not the first time.

A few years ago, I went to an appointment at the hospital in Perth, Western Australia, where I was to deliver my first baby. When the midwife asked me if there were any hereditary conditions in my family's health history, I told her about my brother.

"He was diagnosed with schizoaffective disorder and severe depression with psychotic features about six years ago," I said.

She wrote this down on a piece of paper in my file.

"It may be hereditary. He takes medication for it, though."
"Where is he now?" she asked, still jotting notes.
"He lives at home with my parents and attends university," I said.

At this, her pen stopped, and she looked up at me. "He's going to university? He's not institutionalized?" she asked.

In May, my brother graduated from a university in Utah with a bachelor's degree.

Clint shouldn't have graduated. In fact, he probably shouldn't be alive. According to Rethink, a mental illness charity in the United Kingdom, 30-40 percent of those who suffer from schizoaffective disorder will attempt suicide during their lifetime, and 10 percent will succeed.

Clint has experienced auditory and visual hallucinations for as long as he can remember. He is not sure when they began, but he knows that he was experiencing hallucinations when he was 13 because during that year he wrote about them in his journal.

Clint remembers that at first, the images he saw and the voices he heard were playful and friendly. Out of the chorus of hallucinations, a few male figures featured prominently among the others.

But as time wore on, the figures turned dark, violent and demeaning. Clint wondered where the hallucinations were coming from. He tried as hard as he could to block them out.

But they wouldn't go away. Clint couldn't get them out of his head. He blamed himself. He could see that no one else was hearing what he was hearing or seeing what he was seeing, so he deduced that because his thoughts were bad, then he was bad. Clint believed he experienced hallucinations because he was a sinner. He thought the hallucinations were sent to him by the devil to tempt him.

As Clint grew into adolescence, the images and voices became increasingly violent and intense. They would challenge him to harm himself.

One day when Clint was 16 and alone in the house, one of the male figures dared him to stick the barrel of a shotgun under his chin. Clint resisted, but the hallucination wouldn't let up. It yelled at him over and over again, telling him it had to be done.

At the time, our dad kept an unloaded shotgun in a corner of his closet next to his tennis rackets. The last time he used it was before Clint was born when he went skeet shooting.

Clint took the gun from the closet. He sat at the foot of our parents' bed. He was crying. He wanted the voices to stop. He put the butt of the gun on the ground between his feet and leaned over so that his chin rested on the barrel. He pulled the trigger.

Then he lay on the bed and began to cry. He thought he was losing his mind.