Case study

'I was one of the lucky cases...I'm enjoying my life again.'

'I was one of the lucky cases...I'm enjoying my life again.'

Darren Hughes (24) is putting his life back together after a paranoid psychotic episode that began seven years ago.

The young man from Skerries, Co Dublin believes his psychosis was brought on by cannabis abuse, coupled with experimentation with LSD, ecstasy and magic mushrooms. It has been estimated that drug use doubles the risk of psychosis. However, he also points to a "faint trace" of mental illness in an earlier generation.

Hughes had dabbled in cannabis use since he was about 13 but he started smoking hash "pretty much 24/7" for two years after he did well in the Leaving Cert.

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College plans went out the window and he gradually slid into psychosis. He moved away from home, cut himself off from everyone and "never left the room for a year".

He was growing increasingly paranoid and psychotic, and then he heard a voice. Hearing voices can be a frightening and negative experience for most people, but Hughes says this voice was positive because it advised him to see a psychiatrist. "It said: 'lie down, get into your foetal position and listen to me.' It was like a real person but I knew it was a voice in my head."

He visited a GP and was prescribed antidepressants but didn't take them and continued smoking. However, matters came to a head soon after when he was hit by a car. His distressed state was noted and he was admitted to St Ita's psychiatric hospital in Portrane at the age of 19.

Hughes was not told where he was and in his psychotic state he thought he was in a place for people who had turned into animals. "I needed to have my situation as fully and as clearly and as sensitively explained to me as possible and that didn't happen," he says.

After months of seeing no one, living "in mortal fear of the outside world", he was thrust into a large ward surrounded by people.

Their families came to visit and he frequently overheard families telling other patients "you're not mad - they're all mad".

He felt very vulnerable and the only thought running through his head was, "I need time alone".

He believes psychiatric nurses should improve their "people skills", pointing to one particularly kind nurse. "I can't describe what it was about him that made me feel assured, but there's definitely some sort of skill that nurses can acquire."

During his illness he says he lost all dignity and self-esteem. "The things that I did, I can't tell people. I would be extremely ashamed but I'd like to talk about them because I don't feel responsible . . . I wasn't well." He feels there is too much emphasis on medication in hospital, "and not enough on person-to-person guidance".

He also feels psychologists and psychiatrists should use fewer scientific terms and talk in "normal" language about illness and recovery.

Today Hughes is still on medication but is slowly reducing it. He is involved in the Basin Club, a drop-in centre organised by Schizophrenia Ireland. Next year he is planning to go to college to do a degree, perhaps in English.

"I was one of the lucky cases. I'm relatively healthy. I'm enjoying my life again," he says. "I have faith in my future. I trust my ability to choose again."

ALISON HEALY