Hearing voices

A young man shares his experiences with schizophrenia, and how he copes with the condition

Rafi* experienced what he calls his “first complete break from reality” when he was 20 years old, on a seemingly ordinary and sunny afternoon in Melbourne, Australia. He had just finished his last class at university, and was waiting for his room-mate at a local cafe.

“I saw this group of men, all dressed in black suits, walking behind me from campus,” he recalls. “After sitting down with my coffee, I noticed they were there in the cafe, whispering about how they were going to hurt me. I turned to get a proper look at these guys, and they just didn’t… look human. Like, their faces were all wrong; their eyes were just slits, and their mouths were way too big with sharp teeth. It was terrifying, I couldn’t move from fear, but I knew I had to get away from these things.”

It was at this point that his friend arrived, and Rafi went into a full-blown panic. “Seeing my friend broke the fear, and I started screaming for help, that these evil things were going to tear my brains out if we don’t get out. He was obviously confused; the cafe was empty except for us. Some part of me knew that this wasn’t right, but how could I ignore what I was seeing with my own eyes?”

In the following months, Rafi’s hallucinations would escalate, ranging from the strange non-humans stalking him everywhere he went, to the voices in his head telling him to harm himself. “I remember standing over the bathroom sink in tears, with this voice in my head telling me that I’m an ugly loser so I should just slice my face open with a razor blade. I was lucky that my room-mate came home in time to talk me down. He’s still a close friend, and I’m so thankful for having him in my life,” he says.

After a trip to the university’s health care services, and then a flight back home, Rafi found a reason for his visions: schizophrenia.

Not just hallucinations

The World Health Organization (WHO) estimates that there over 21 million people worldwide living with schizophrenia. The condition is characterised by severe disruptions in thinking and perception, and often includes psychotic experiences, such as hearing voices or delusions. There is neither a definitive cause nor cure for the condition, although with many living with disease are able to live regular lives with the right treatment and support. Unfortunately, the WHO also estimates that only one in two of suffers receive adequate care.

Schizophrenia usually starts manifesting in the late teenage years or early adulthood. Now aged 29, Rafi realised that he started experiencing symptoms a few years before his formal diagnosis.

“I started hearing these voices internally when was I in secondary school. You know how in cartoons, they show you having an angel on one shoulder, and the devil on the other? It was like that; the first voice was a kind female one, and would usually reply to whatever I was thinking about at the time. The other voice, male, was the exact opposite. He would assume the worst about everything I did, and kept telling me I was a failure, no one liked me, and that everyone hated me. I thought these voices were normal, like everyone had these dialogues with themselves,” says Rafi.

At university however, Rafi discovered a newer, more menacing voice; a demonic-seeming entity that would constantly pester him with thoughts of self-harm. “By this point, I was too ashamed to tell anyone else,” he says. “Sometimes when these voices decided to appear, I could barely hear my own thoughts, or even other people talking to me, because it was just this chaos going on in my head. When the visions started, it was a clear sign I needed help.”

Following his diagnosis was a painful ordeal of getting a treatment regime that worked well. “My initial cocktail of medications either made the depression worse, or left me completely numb. I couldn’t function properly; sleeping for over 12 hours was the new normal. I isolated myself from the world, and just stayed at home most of the time,” says Rafi.

What helped him progress with managing his illness was utilising cognitive behavioural therapy (CBT) techniques, and making some crucial lifestyle changes. “CBT for me was about reprogramming unhealthy thought processes, and taking a detached view of these voices,” he explains. “By clearly identifying the voices, I could train myself to say ‘this isn’t real’ when I do hear them. I also really have to watch my diet, exercise regularly, and make sure I get enough sleep.”

Along the way, Rafi and his doctors found the right dosage of medications to help him live his life as fully as possible. “They still make me feel a little drowsy, but I can get to work and have a social life now. What has really changed is that I have to be strict with my habits; the way I eat, what time I go to bed, and so on. When people find out that I have schizophrenia, they don’t believe it; they’re like, you look so normal. My reply is, how is a schizophrenic supposed to look like?” he says.

Ultimately, Rafi believes that the key for managing his condition was the support he received from his family. “I know I’m lucky; my parents were with me every part of the way, and they could afford to get me the best treatment. Not many people are in the same boat,” he says.

As testament to how well he’s coping with the condition, Rafi is currently back in Melbourne to complete his degree in computer science. While he’s proud of how far he’s come, he still feels uncomfortable sharing his experiences openly. “I mean, this is why I choose to leave the country to continue with my studies,” he says. “I’m not saying that mental health support here is flawless, but at least I have people I can trust to help me manage — like my lecturers and counsellors. All my close friends here know my situation, and they don’t judge me. Back home, I couldn’t even tell my relatives, because everyone thinks we’re all violent serial killers. But the only person I was ever a danger to was myself,” he says.

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