I am a 32-year-old man. I have been diagnosed with mental illness since my teens, and have been a chronic poly-substance “abuser” since the same time.

I have spent most of the past six years in jail. During the times I was defending myself, I got to see the dynamics of my drug use and mental illness (dual diagnosis) played out in the courtroom. I have had dozens of psych reports and drug and alcohol assessments picked apart by judges, barristers, solicitors and prosecutors. I took the time to study these reports myself, and although I did this mainly for self-preservation, the process added to my personal growth and understanding.

My current diagnosis is chronic schizo-affective disorder: that is long term schizophrenia coupled with a mood disorder (mine being manic depression). I have also been diagnosed with obsessive compulsive disorder and anxiety disorder.

I started smoking pot when I was 14. Now, I am sure hallucinogenic drugs like pot brought my illness out earlier than it would have otherwise. But there is no way of knowing how I “would have turned out” if I didn’t start smoking at that age. Pot certainly affected me differently to my friends. By the time I was 17 I had symptoms of serious mental illness, and my deterioration when smoking was obvious. None of my friends shared these symptoms.

One of the first questions professional clinicians asked themselves when they found out I smoked pot was if I was experiencing drug-induced psychosis. This was a difficult question to answer, because before I was 21 I had never had any reasonable amount of time off drugs to compare.

When I was 21 I did 16 months residential rehab on a court order for attempted armed robbery. Thirteen months of it was at the GROW community, a 12-step program for people with mental illness. I spent several more months at a GROW house in Canberra afterwards.

Within six months of leaving rehab my symptoms returned, and I started using methamphetamine (we mentally ill always go for the most destructive drugs, of course!). Later I spent five years in prison, which finally confirmed to me that my mental illness was above and beyond my drug taking, and I accepted what I had never accepted before: that I would need some proper medication.

So what can I say about mental illness and drug use? Does one cause or trigger the other? I don’t want to make too many sweeping conclusions on such a complex issue, but my forensic experience (being picked apart as a dual-diagnosis criminal) has led me to conclude that many mentally ill people use drugs to cope with their symptoms. If the drugs exacerbate those symptoms, then they will use more drugs to cope with the drug-induced stuff – a vicious circle. This is certainly what I did, and I told any concerned well-wisher (also known back then as an interferer or accuser) that I knew exactly what I was doing. This of course raises the question of a mentally ill person’s ability to always make sound judgments.

I feel that in the past my priorities were out of whack. While I should have been staying drug-free (or managing my drug use) and getting my life together, this didn’t actually appeal to me as much as throwing “Big Brother” off. I was firmly convinced that my thoughts were being read, and we as a society were victims of a massive conspiracy. So falling into the trap of being successful and enjoying life was for the suckers. I had outsmarted them with years of rehab, jail and suffering.

I don’t feel that unwell at the moment: maturity and understanding what is happening to me has made all the difference. Looking back over my late teens is a traumatic experience: being paranoid, withdrawn and isolated; seeing and hearing things; and having no idea what was happening to me. I tried to kill myself a few times, and looking back I am just lucky it didn’t work. (The one piece of advice I have for a young person with similar issues is to have faith in one thing: that time brings answers. It certainly has for me.)

These days there is some “psychotic interference” and the occasional hallucination, but mostly my mind is clear. My understanding and experience give me hope and confidence through my difficult times. My search for truth – for what is reality – has given me a strong, rational mind: the full survival kit.

So, do drugs cause mental illness or does mental illness lead to drugs? You may as well ask what came first: the chicken or the egg?

Illustration by Glenn Smith

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