The voices are always there. In the good times they amount to little more than the background chatter of a cocktail party; in the bad they increase in intensity and volume, talking to her and to each other, with such venom that she cannot bear, even when they've receded again, to repeat their monstrous words.
Janey Antoniou has lived with schizophrenia for 15 years. Or rather that's the period of time since she was diagnosed; in retrospect the symptoms began long before.
"In fact I thought voices were something everyone heard but no-one spoke about," she says. "That's how I rationalised it until one day I mentioned them to a colleague. I said something about 'they say' and she said, 'Who say?', and I told her, probably because I trusted her. And she sort of went, 'Ah, ha'."
Janey is 42 now, sweet-faced, soft-spoken and slightly diffident. Meeting her in a room full of people, as I first did, there'd be nothing to mark her out as a woman who's spent a total of two years in mental hospitals, sometimes voluntarily, sometimes not. But then one of the most remarkable things about Janey is not that she has regularly suffered schizophrenia's most florid symptoms - delusions, hallucinations and paranoia - but that in between she has managed to carry on with her job as a molecular biologist.
"I've always been aware at some level of the need to maintain a level of normality as if what was happening inside me was separate from doing what one had to do," she says. "I was once caught trying to hang myself in hospital and the psychiatrist said, 'You'll have to stay here now,' and I said, 'But I can't, I've got work to do'."
In retrospect, the warning signs began early in childhood. She can remember vividly at the age of seven a sense of not being able to get comfortable in her body and a feeling something was dreadfully wrong. Her father was an atomic physicist at Aldermaston, "a genius with eccentric traits who always wanted to run off and be a tramp", and Janey and her siblings were left to run wild. She had friends, but never close ones. "I was always walking and worrying though I never worked out what I was trying to walk away from," she says. At 14, fixated by a line from a hymn, 'Take my life', she tried to kill herself by hanging herself from the bell ropes at church. It was only the arrival of a parent come to retrieve his daughter's cardigan that saved her. She went to her GP but refused to see a psychiatrist.
At Sussex university, where she studied biology, her behaviour at times became distinctly bizarre: going without shoes, arriving in Edinburgh without money, threatening to slit her throat with a penknife. But she still managed to persuade a psychiatrist she was OK. After graduating she took a job in a laboratory, met and married Michael, and moved to Lincoln, Nebraska, where her husband took up a university post. She recalls the three years there as a period of relative calm. It was after the couple's return to England, and in a new lab job, that Janey suffered a major breakdown. "I don't remember anything particular triggering it, but I'd begun acting in strange ways, curling up in a corner of the lab, shaking and glassy-eyed, and I think I once hurled a glass at something which wasn't there."
The collapse - and finally being diagnosed with schizophrenia - began the search for an appropriate drug which would control the symptoms without side-effects. She must have tried, she says, nearly a couple of dozen over the years. The one which works best is the anti-psychotic sulpiride: she takes three to five tablets each morning and evening depending on how she's coping.
"It still always feels though as if I'm thinking through a fog, but if I don't take it the voices get louder. At one time if people told me I was getting ill I would deny it but these days I'm more aware of the warnings. Not being able to cross the road, to put that logical sequence of thoughts and actions together, is always a sign."
She has in the past stopped taking her medication. "A strange logic applies. You don't want to be ill, you're ill because you're taking medication, if you don't take it you'll be well". But she stresses she has only been violent to anyone other than herself on one occasion.
"I was in a police station and I wasn't very well. What I should have been told is that I had to wait for my husband to collect me, but of course nobody talks to you because they think you're mad. So I tried to leave, the police tried to stop me and I lashed out. It escalated to the point where four of them had to sit on me.
"I wasn't out to kill or beat anyone up. It's just that I hadn't understood the intentions of those around me and I felt I was fighting for my life. What people have to understand is that with this illness you have to fit what other people are doing into your reality."
Often a schizophrenic's behaviour provokes reactions in others which reinforce a delusion. "I was once convinced that I was going to be conscripted into the Filipino army, don't ask my why, and so I went down to Soho because I thought with so many people around they wouldn't be able to find me. But of course when you're behaving strangely people stare and whisper and that makes you even more paranoid."
In the early days of her illness she saw 2ft tall men with moon-like faces and tiny horses with scorpions' tails, but - as far as she knows - she's had no visual hallucinations for years. "What is so frightening is that I never know when I can trust myself. Once you've been out of control you're never quite sure again. So if a van with a loudspeaker goes past the end of the street is that real or is it me?"
She now works with the Institute of Psychiatry and the National Schizophrenia Fellowship, trying to counteract, as she puts it, the image of 'the nutter with the knife'.
"I can't deny these cases happen and I understand how people are scared but it rebounds on the rest of us," she says. One of the exercises she and the NSF do with the police involves sitting an officer in a chair with a tube in each ear and feeding him gibberish through one and paranoid statements through the other while he or she has to answer questions. "It's fascinating how quickly they lose concentration."
Janey has been lucky to have the love and support of her husband throughout her illness, but it remains what she describes as "a bumber".
"I think the fear is the worst," she says. "Sometimes when I'm at my most dramatic and silly I think I can't stand it anymore but there's no point pitying yourself, you have to get on with it. Other people have it tougher than I do: mentally and physically."
Useful stuff
Contacts:
National Schizophrenia Fellowship, 28 Castle Street, Kingston-upon-Thames KT1 1SS, tel: 0181-974 6814. From 10am-3pm.
Sane, 1st floor, Cityside House, 40 Adler Street, London E1 1EE, tel: 0345 678000.
Schizophrenia Association of Great Britain, International Schizophrenia Centre, Bryn Hyfryd, The Crescent, Bangor, Gwynedd LL57 2AG, tel: 01248 354048.
In print:
Schizophrenia, S Frangou and RM Murray.
Pocket Reference to Schizophrenia, Martin Dunitz 1996 Levine and others, Science Press 1993.
In Your Right Mind, Dr T Stuttaford and Dr T Sharma, Faber and Faber 1999.
Links
www.schizophrenia.co.uk
www.mentalhealth.com
