Like more than half of people with serious mental illness, Smith suffered from anosognosia, a condition where your brain doesn't recognize it's sick
By Eileen Finan
Twelve years ago Eric Smith believed he was a secret agent who needed to kill his mother to save the world — like half of all people with schizophrenia, Smith didn't understand he was ill and he would refuse treatment.
Smith, now 40, is one of the rare, lucky ones who found his way back to reality, but only after years of pain for him and for his family. "My parents lost so many years of their lives with my illness — their love was unwavering," he says. This is the story of how he came trust his brain again.
One summer day in 2011, Smith walked into his mother's home office and calmly delivered a chilling message. "Mom, they're telling me I have to kill you." He explained the thoughts running through his confused mind: "I am an agent, and I'm getting information from this," he said, pointing to his watch. "But I'm not going to listen." He ran outside and hurled the watch behind their San Antonio home. But the voices didn't stop.
"I was terrified," Nancy Smith recalls. "Eric was not there — this had become his reality. We needed help beyond help."
Eric, then 28, had been coping with symptoms of schizophrenia for more than a decade, but his illness had reached a crisis point. "My parents and psychiatrists saw how psychotic I was," says Smith. "But I was convinced I was saving humanity from the next World War. I was held hostage by my own mind."
More than 14 million Americans live with serious mental illness, such as schizophrenia and bipolar disorder, and, like Eric, more than half suffer from anosognosia (ahno-sag-NO-zha), a symptom where the brain is unable to recognize it is sick. "Someone with the condition is as blind to the fact that they have a brain disorder as a person who's in a coma," says Dr. Xavier Amador, clinical psychologist and CEO of the Henry Amador Center on Anosognosia.
Produced by dysfunction or damage to the frontal and prefrontal lobes that can occur with psychotic disorders, anosognosia can "wax and wane" but rarely goes away, Amador says. "Eric is one of the few lucky ones." Those affected often refuse treatment and "it can turn loving relationships into hostile relationships."
In his earliest years, Eric showed no hint of the problems to come. "He was a precocious child— extremely bright," says his mother. In elementary school he was composing original piano pieces, but he began failing classes in middle school. By high school he was taking drugs (marijuana, MDMA, LSD, cocaine) and acting out, and a psychiatrist suggested he might be experiencing the onset of bipolar disorder or schizophrenia, conditions that often begin to present symptoms in teenage years. "It turned our world upside down," says Nancy, 74.
In his junior year of high school he dropped out and got his GED. Not long after, the delusions began.
Eric became convinced he was a code breaker for the FBI. "I sat awake three nights in a row surfing the Internet for threats against world leaders," he recalls. "I felt if I went to sleep, a leader would be assassinated."
He would come to his parents' house before dawn, pounding on the door in a state of self-delusion, once telling his father, "I'm going to break your face." ("I wasn't sure my dad was my dad, or if a spy replaced him," Eric says.) Although he never acted upon his threats, "we slept with our bedroom door locked," Nancy says.
More than anything, they were worried about their son, who refused pleas to get help. "He was living in his car, and there were days we didn't hear from him. We didn't know if the next call would be from the hospital or the police," Nancy says. "Would somebody kill him? Would he overdose? What would happen to him on the street? I can't tell you how many nights I cried myself to sleep."
By 2009 they were desperate and called a psychiatrist Eric had gone to for advice. Despite Eric's disturbed statements, they were told they'd have no chance of committing him to a mental hospital involuntarily. "The doctor said, 'The only thing you can do is hope you can get him arrested,' " says Nancy. When Eric came back to their home, police took him in for trespassing.
As Eric sat in jail — eating only butter because he thought anything else would poison him — his mother begged authorities to keep him locked up until a bed in the state hospital was available. After 30 days he was transferred, but it took two more hospital stays over three years, and a court-ordered treatment program known as Assisted Outpatient Treatment, to find the drug that helped (Clozapine, an antipsychotic) and the motivation to stay on it. "Suddenly his mind worked the way it was supposed to," says Nancy.
Eric, who went on to complete a degree in psychology and a master's in social work, lives at home with his parents, and says the family is making up for lost time. "There are years no one can get back," he says. "But we've gotten to know one another again.
Stable since February 2012, he's had no recurrence of his anosognosia. "I feared for years it would return — and I obsess over the fact that I need to take my meds every day — but my psychiatrist tells me I have a minimal chance of ever returning to be hospitalized."
Life today "feels worth living. I'm incredibly happy," says Eric, who is eager to help others as a mental health advocate. "I try my best to give back to society and have my family see that what they went through wasn't all for nothing."
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