3.Bethany Yeiser — Proffer

BETHANY YEISER: My name is Bethany Yeiser, Y-E-I-S-E-R. PROFFER DIRECT EXAMINATION

BETHANY YEISER: Okay.

BETHANY YEISER: Cincinnati, Ohio.

BETHANY YEISER: Yes.

BETHANY YEISER: Mentor, High School.

BETHANY YEISER: Mento High is a suburb of Clevenland.

BETHANY YEISER: 4.0.

BETHANY YEISER: I did. I had a half tuition scholarship to attend University of Southern California to study biochemistry and molecular biology.

BETHANY YEISER: Well, I was originally attracted to the excellent music school. I planned to study violin, but I changed to molecular biology.

BETHANY YEISER: Since I was seven.

BETHANY YEISER: Biology, that's correct.

BETHANY YEISER: I wanted to do clinical trials to obtain an M.D. or Ph.D.

BETHANY YEISER: I was thinking about HIV or cancer.

BETHANY YEISER: No. During my senior year, I had my first psychotic episode and, suddenly, my best efforts produced failing grades and I failed to graduate.

BETHANY YEISER: I did.

BETHANY YEISER: I received my molecular biology degree from the University of Cincinnati in 2011, after I recovered from schizophrenia.

BETHANY YEISER: I write and speak about schizophrenia. I write a blog for Psychology Today and -- and I manage the CURESZ Foundation, which stands for Comprehensive Understanding via Research and Education into Schizophrenia.

BETHANY YEISER: Yes.

BETHANY YEISER: I was diagnosed with schizophrenia in March of 2007.

BETHANY YEISER: Yes.

BETHANY YEISER: Yes. I wrote my memoir Mind Estranged: My Journey from Schizophrenia and Homelessness to Recovery published in 2014.

BETHANY YEISER: Amazon.

BETHANY YEISER: Yes.

BETHANY YEISER: My story, especially being a high achiever, getting excellent grades before the onset of schizophrenia, delusions, believing that I was the next prophet in 2000 years. And, of course, I spent a lot of time talking about my voices. I wanted to explain to the general public the experience of hearing voices, which are not like regular thoughts. I wanted to explain how the voices affected my behavior. Schizophrenia is a treatable brain disorder similar to Parkinson's, Alzheimer's and stroke. A lot of people think that when a person with schizophrenia is experiencing voices, they can choose to follow or to ignore those voices. I wanted to help the general public understand how compelling the voices were.

BETHANY YEISER: Today, yes.

BETHANY YEISER: About two years.

BETHANY YEISER: I write about mental illness and I write about homelessness. And I spend a lot of time describing my symptoms of schizophrenia. I was also briefly incarcerated two times. I was incarcerated for trespassing on the University of Southern California campus where I had once been an honor student while I was homeless. And I was trespassing while I was acutely psychotic and hearing voices. I want to help people understand that if I had been able to choose to ignore the voices, I never would have trespassed on the University of Southern California campus. I want people to understand and have more compassion on people with schizophrenia.

BETHANY YEISER: I've written for some major websites, such as Treatment Advocacy Center website.

BETHANY YEISER: During the last five years, I've been lecturing for doctors, representatives of churches, clinics, non-chapters. I do a lot of speaking.

BETHANY YEISER: It was founded in 2016, we started work in 2017.

BETHANY YEISER: A psychiatrist named Henry Nasrallah and a Board including 11 other people, including psychiatrists.

BETHANY YEISER: Comprehensive Understanding via Research and Education in Schizophrenia, CURESZ.

BETHANY YEISER: We promote cutting edge and underutilized medications, such as my medication called Clozapine, which has kept me in full remission for 11 years with no relapse. We also highlight stories of what we call schizophrenia survivors. These are people who are thriving despite the schizophrenia diagnosis. We seek to educate the public about schizophrenia as a brain disorder to try to fight the stigma with schizophrenia. For example, seizures used to be called a mental illness. We'd like to see schizophrenia always called a brain disease and not a mental illness.

BETHANY YEISER: Yes. One of the biggest misconceptions about schizophrenia is understanding of the voices, thinking that people with schizophrenia should just be strong, should buck up, should pull themselves up by their bootstraps and just ignore the voices, just stop paying attention to the voices, just act normal. But again, schizophrenia is a brain disease, a biological brain disease, like Alzheimer's. You wouldn't tell someone with Alzheimer's disease to just buck up and to just act normal because you understand they have a disease that's influencing their behavior. So we seek to clear up these misconceptions about schizophrenia.

BETHANY YEISER: So I spent three years at USC. I had a steady decline in my ability to focus. I went to Africa the summer after my junior year of college. Came back from Africa and, suddenly, I'm having these delusions. I'm believing that hundreds of millions of people around the world are personally counting on me to change their living situation. I started believing that I'd be the next Mother Teresa, I'd be a prophet. And while I'm having these delusions, my grades are just dropping and I'm hardly even able to pass. The illness changed my personality. I was irritable. I wasn't making a lot of sense. I was rude. And I was paranoid of my parents. I thought they would stop me from becoming this prophet. About six months later, I moved out of the dormitory, rejecting all help and became homeless. I started sleeping in the University library every night. I hid for three years. And then my fourth year homeless, I started having hallucinations and sleeping outside.

BETHANY YEISER: I had a happy, normal childhood and I had a fantastic relationship with my mom and dad. That's why it's amazing to me looking back that I absolutely refused to speak with them when the illness came on because we had been so close when I was younger.

BETHANY YEISER: Four and a half years.

BETHANY YEISER: Yes.

BETHANY YEISER: I was homeless from March 3rd, 2003, to March 3, 2007, when I was picked up by police and taken for evaluation. I was screaming at the top of my lungs to the voices and was picked up and evaluated.

BETHANY YEISER: Yes.

BETHANY YEISER: For the first three years, I was hiding in University libraries. I still had my University ID. They didn't check my ID. They just noticed that it looked like a valid ID. No one knew that I had failed all of my classes. And then during the summer, there was a certain dormitory where I had lived as a student in good standing. And I knew that half of the dormitory was empty for the summer and I would sneak into the dormitory every night, sleep there and leave very, very early in the morning. So I lived like that for three years. I was looking through garbage for food to eat. And my whole life was centered around my delusions. I thought I was going to become, again, this big international figure, rich, help hundreds and millions of people in poverty.

BETHANY YEISER: I started hearing voices in January 28th of 2006. I was sitting on a park bench on the University of Southern California campus and I hear this chorus of students' voices inside my mind. They're insulting me, telling me I'm homeless, telling me again and again and again. It was the most irritating thing I could ever imagine. And then they changed and they confirmed my delusions and talked about how I would marry a politician, have millions of dollars and make a contribution. And they would go back and forth and back and forth between negative and positive.

BETHANY YEISER: So after six months, I started having what were called -- what the doctors called command hallucinations. They could be simple things like walk to the right, walk to the left. I'd be walking in a zig-zag pattern. They would scream and scream inside of my mind until I did whatever they were telling me to do. I started taking these long, long walks for miles and miles down to Los Angeles. They would scream at me and say look for food when I wasn't even the slightest bit hungry. I started looking for -- you know, for food in the garbage even when other people were around and saw. The voices were unbelievably compelling and they were the most irritating stimulus. I couldn't ever imagine -- basically, whatever they were telling me to do, I just did from taking long walks to hitting myself to looking for garbage to eat. All I really wanted in my life with this in my life was to somehow escape the commands of the voices. It was -- again, as I mentioned before, they weren't something that I could follow or choose to just ignore. If they were something that I could choose to follow or ignore, I might not have been diagnosed with schizophrenia. They were also -- they were also a lot like my conscience. You know, somebody might admit to something they've done wrong because they're conscience is pushing them to, even if they know there will be punishment. And the voices, they felt a little bit like my conscience. It almost felt like whatever they did was -- whatever they told me to do was the right thing to do.

BETHANY YEISER: No. No.

BETHANY YEISER: Well, I very firmly believed I wasn't mentally ill, so I figured that well, maybe everyone has this experience and I thought maybe the important thing is to just not talk about it because nobody else is talking about it, so I shouldn't talk about it either. I was very sick.

BETHANY YEISER: Yes. So I would hear voices night and day, 24/7 and then I -- even when I was homeless, I put up this facade. I was a really, really good liar. I might go to a public park and people would ask where I lived and I had this false address. And I would wash up in public bathrooms, I would try to keep the best hygiene I could. And when I was around other people or I was afraid, the voices would be distracted. So I might be screaming at the voices and then, say, a police officer comes to me and says what's wrong, were you screaming? No, I wasn't screaming. There's nothing wrong with me. You know, I was hearing voices for 13 months before I was picked up by police and taken for an evaluation. And even at that point, when the voices were so bad, when I heard them for 13 months, they almost didn't admit me to the hospital because I was able to put up such a great facade and to convince people that nothing was wrong with me.

BETHANY YEISER: Yeah, I would have conversations. I won't say it was screaming. I could be mumbling to myself because of the voices.

BETHANY YEISER: Yeah, so the voices, again, they began like January 28th, 2006. A few days later, I was taking a shower at a friend's apartment and there were these three guys who were outside the window who were looking at me when I was in the shower. And because of their specific comments and very rude and derogatory, I could tell they could see me in the shower. So I got out of the shower to look through the window to see these three men and there was no window. So I was looking for a sunroof to see where these three guys were coming from. No sunroof. And it took me a few minutes for me to realize that those guys were not there. Same with visual hallucinations. I'd walk by a library and saw the name of the library was changed by one letter. Eventually, I would get to the point where I couldn't check the date on a newspaper without hallucinating and I didn't know what day it was.

BETHANY YEISER: Yes. I looked at myself in the mirror one day and the image I saw in the mirror was morphed. It looked like a cross between me and the character Lisa from the show of the Simpsons. Very bizarre and I felt afraid.

BETHANY YEISER: Paranoia wasn't my main symptom. My biggest problem was the voices, but I was paranoid that my parents would stop me from becoming a prophet, from making a worldwide impact. You know, they contacted my friends, my church, my professors. They did everything they could. They wanted to make amends. They wanted to be in my life. I would not speak with them.

BETHANY YEISER: Well, for the first three years, I became this expert at washing up in public bathrooms in the early hours of the morning. I would wash my hair with hand soap. And then the fourth year, when the voices came on and I started living outside, my hygiene just slipped. It was like I was giving up. And when I was eventually picked up for evaluation, they were able to tell that I had been living outside for a long time.

BETHANY YEISER: Originally, when I was looking for garbage to eat, I would be very, very careful to only look for food when nobody was around, nobody was watching and I lost a lot of weight. I probably weighed about 20 pounds less than I do now. And then as the years went by, as I was homeless, I didn't even care if people saw me looking for food in the garbage. I'd be looking for food in the middle of the day that people had discarded.

BETHANY YEISER: A lot of people with schizophrenia wax and wane. Through my foundation, I'm not a doctor, but I encounter people with schizophrenia all the time and a lot of people have that experience. For me, it was very constant. They were always there about the same intensity.

BETHANY YEISER: Oh, yeah, yeah, especially those first three years before the voices began. I mean, I was hiding on the University campus sleeping in the library. I mean, I made friends. I was a really, really good liar. You know, I had friends who knew that I wasn't in class, but they didn't know that I was homeless. And even when the voices began, I was very rationale. I was able to put up this great fasad. And again, when I was finally picked up by police and I had lived outside and heard voices for 13 months, I was almost able to talk my way out of it because the voices were just so distracted when I was with other people.

BETHANY YEISER: Well, they never went away completely, but I remember after I had heard voices for several weeks, a friend invited me to a party. And I was in her car, she drove me there, she didn't know I was homeless, and I could hear the voices very faintly in the distance, but they were like a mumbling. I was able to ignore them pretty well. I went to the party and one of the women there had a laptop computer with Wifi, it wasn't plugged in. And I remember seeing a computer on Wifi before and I was really paranoid. I thought that maybe it was plugged in and she was just lying about it that it wasn't really plugged in. So all these different crazy thoughts were going through my mind, but I was able to pull it together. Now, I'm sure no one at the party knew, you know, that I was paranoid and I was having these hallucinations. It's kind of like I was a volcano that was about to explode, but all people around me could see was the mountain. They couldn't see that I was about to explode.

BETHANY YEISER: No. No. Absolutely not. I thought I was completely fine. I had a symptom, which doctors call anosognosia, which means lack of insight. And I was a hundred percent absolutely sure that nothing was wrong with me and this is very typical in schizophrenia. Half of patients or so, at least, at first have no -- not even a clue that something is wrong.

BETHANY YEISER: I was given food. I remember I had Cheerios and a banana. I didn't have to look in the garbage for food. They gave me a uniform that was clean. I was sleeping on a bed at night. There were actually all these perks to being in jail. My second time in jail, there was a lot more natural light and the conditions were a lot better and I was almost ready to just stay in jail. My life home had been so bad that, you know, there was a lot of advantages to be in jail. And another thing that happened when I was jailed was I was afraid and the voices became way better. I was never evaluated for mental illness while I was in jail because I was just so good at putting up the facade.

BETHANY YEISER: So my third being picked up was March 3rd, 2007. The voices were saying walk to the right, walk to the left. I'm up in the morning walking this zig-zag pattern around the churchyard at the command of the voices. I'm screaming back at the voices. And then a police officer sneaks up on me and I find my hands behind my back. I didn't even see him coming. He told me I was being taken to be evaluated in the psych hospital. And I thought well, that's great. You know, there's nothing wrong with me, they'll let me out right away, of course, you know. So when I was at the psych hospital, they called my parents. They hadn't called my parents when I was in jail. Again, it had been four and a half years since I had spoken with my parents. And my parents got on the phone, called the social worker and explained to them everything that had been happening. Because they realized that, you know, I was so good at putting up this facade that they may not have even kept me in the hospital. They may have discharged me in the streets. So because my parents convinced them to keep me in the hospital, they did. I was there for about two and a half weeks and, of course, I started medication.

BETHANY YEISER: My first medication was called Risperidone.

BETHANY YEISER: It was like being on chemotherapy. It was worse than I could have ever imagined. I had severe, what they call, EPS, extrapyramidal side effects. Extremely rigid muscles. I had a side effect called akathisia. It's where you are extremely restless. More restless than I had ever been or could ever imagine. Sitting for five minutes was like for sitting three hours used to be. I had a flat affect because of the medication. Anhedonia, got no joy out of hearing my favorite music or seeing my favorite painting. Rapidly gained lots of weight, to ten pounds. Sleeping 16 hours a night or more, waking up exhausted. This medication, it was my worst nightmare. I had a friend who was taking Risperidone, the same dosage. She was premed, going to school full time, getting A's. For some people, the drug is your miracle. For me, the drug was my nightmare. And when these side effects kicked in, I thought to myself I know who I am. I do not need this medication. I am strong. I am an ordinary person. I cannot have schizophrenia. So I went off the medication.

BETHANY YEISER: I thought it wasn't because when I was on Risperidone, the voices were louder than they had ever been. They were screaming at me. I couldn't ignore them, they were so irritating. But -- you know, I thought it wasn't working at all, but the command hallucinations went away. So when the command hallucinations went away, my behavior changed. I started to act normal and then the doctors determined that they were ready to discharge me from the hospital. So yeah, the medicine was working, but I had no idea it was working. I couldn't see it.

BETHANY YEISER: So I was hospitalized for two and a half weeks in Los Angeles and then I flew to Cincinnati to recover at my parents home.

BETHANY YEISER: So I stopped taking the medicine when I was there. And I was feeling great. The side effects were disappearing. You know, I was feeling better and better. I was starting to lose the weight I had gained. And then the voices came back and I didn't even tell they had changed to command hallucinations again. And they were stronger than they had ever been. I was acutely psychotic. And I was at my dad's church that day trying to practice my violin. It was the violin they had given me when I was 13. The violin was my life treasure. It was worth thousands of dollars. It was the most precious thing to me. And the voices told me to break the violin, voices told me to just smash the violin. And I did. And I did. And something inside of me told me it was the right thing to do. And I was -- at the same time, I was devastated that I had broken my treasure. Today, I know there are two types of hallucinations. One's called ego-syntonic. It's when you do something that's consistent with who you are. Something normal, like, you love to go to your favorite restaurant, so you -- the voices are telling you to go to that restaurant. There's another type of hallucination called ego-dystonic, which is what I had when I broke the violin. This is when you do something that you would never do in a million years. It's something that's so contrary to who you are as a person, it's something you would never do. And that's what I was having that day, an ego-dystonic hallucination.

BETHANY YEISER: I found the right medication for me in 2008 called Clozapine. And for the last 11 years, I have been on Clozapine with full remission and no relapse. That enabled me to transfer to UC and finish my degree with all straight A's.

BETHANY YEISER: Yeah.

BETHANY YEISER: Oh, it just means that I don't respond well to pretty much any drug except for the one I take, which is for treatment resistant patients.

BETHANY YEISER: I went through five. And it really looked like I would never get better, I would never go back to school or I would never volunteer or work, I would never have normal relationships. Some people have what they -- experience on Clozopine. I was -- that was me. It was incredible. The voices were finally quiet.

BETHANY YEISER: Risperidone, Paliperidone, Ziprasidone, Aripiprazole and Olanzapine.

BETHANY YEISER: Yes, Geodon is a type of Ziprasidone.

BETHANY YEISER: I was feeling great. The side effects were going away. And then when I was on the Ziprasidone, the voices were slowly coming back. It works fabulous for some people, but it wasn't for me.

BETHANY YEISER: Originally, some. But, you know, before I had schizophrenia, I had a fabulous relationship with my parents, no trauma, happy, normal childhood. And then when I got on medication, it resumed. There was no trauma. I was fine. There was nothing to talk about really. Many patients benefit from all kinds of -- types of psychotherapy, such as cognitive behavioral therapy. What I did benefit from was my doctor sitting down with me, coaching me saying where do you want to work? Do you want to finish your degree? Do you want to play violin again? So he would help me rebuild my life. So I did that.

BETHANY YEISER: Clozapine is sedating for me. I sleep about 11 hours a night. I can't work full time. And I've been very hesitant to drive, so I've decided not to drive over the last few years. So I can't work full time, no.

BETHANY YEISER: Not really. Not really. I'm one of those people, again, that did fabulous on Clozapine. And I've been very stable with no relapse for 11 years.

BETHANY YEISER: It can be. It can be. A lot of people have mild relapse, maybe briefly hospitalized, but many people on Clozapine recover, as I have, and just do beautifully. And also on other medications as well.

BETHANY YEISER: The biggest misconception is that it is a mental illness and that people should just pull themselves up by their bootstraps and act normal, when, in reality, you would never say that to someone with Alzheimer's Disease. You know, this disease -- the voices are not like regular thoughts. They're unbelievably compelling and to this day, I cannot believe that they were so compelling that they made me break my violin. So we want people to understand it's a brain disease. We also want them to understand this is treatable, you know. And today, the medications are not just major tranquilizers like they used to be that wipe you out and make you tired. Today, people on the newer antipsychotics can really have a life, work, volunteer, you know, have normal relationships, have a life. There's a lot of hope.