‘We talk about depression but when it comes to life-long debilitating mental illnesses, we still have a long way to go’

Today is World Mental Health day. Shamim Malekmian talks to a young man who fights a daily battle with a complex ailment. This article appeared in The Irish Examiner on 10.10.2018.

For almost two decades, Gregg Kelly nursed a dark suspicion that everyone in his hometown of Ballincollig, Co Cork, deeply resented him.

“When I was walking down the street, I thought that everyone coming towards me was judging me,” he says. “Going to the shop was kind of an accomplishment for me, I was breathless afterwards.” Gregg, who is now a 27-year-old mental health advocate, lives with Obsessive Compulsive Disorder (OCD) and Schizoaffective Disorder.

His mental ailments remained undiagnosed long enough for him to miss his Leaving Cert exam, scour the internet for the most painless suicide methods and spend his childhood days stuck in bathrooms obsessively washing his hands, to the point of amnesiac.

“You kind of repeat things to get your intrusive thoughts out of your head,” he says.

Dr Eric Kelleher, a consultant psychiatrist at Ireland’s College of Psychiatrists, says patients with OCD tend to engage in ritualistic behaviours to assuage their intrusive thoughts.

“For example, someone might have an upsetting thought that they might cause harm to someone else,” he says. “So, they engage in behaviours that reduce this distress by thinking of other neutralising thoughts or engaging in rituals to remove the possibility that what they worry about could ever happen.” Gregg is soft-spoken, conspicuously shy with a long forehead and short black hair. He wears a cornucopia of colours around his wrist; those are bracelets representing causes he holds dear, among them, suicide prevention and human rights.

The young man was diagnosed with schizoaffective disorder two years ago, despite receiving a diagnosis of OCD at 17. For Gregg, that meant living with severe paranoia, a hallmark of schizoaffective disease, for eight more years, causing suspicion to feel as natural as breathing to him.

Dr Kelleher says schizoaffective disorder is a complex mental ailment that features mood-switching symptoms of bipolar disorder and psychotic episodes of schizophrenia, often misdirecting doctors when it comes to diagnosis.

“Psychotic features may include delusions, where the person may be convinced something is happening despite clear evidence to the contrary, and hallucinations where they experience physical sensations such as sounds or sights in the absence of a stimulus,” he explains.

Gregg’s Facebook timeline is filled with links to online petitions for various charitable causes, almost always accompanied by a brief text outlining the urgency of the issue. The online platform, however, used to be a significant breeding ground for his suspicious thoughts. He says he counted his Facebook friends, every single day, petrified of not reaching the same number every time.

If someone had deleted me on Facebook, I would think that other people have been talking to them about me, about a mistake I’d made or that they told them that I’m not a nice person,” he says. “Then I would obsessively worry about that.” Over time, paranoia invaded his sub-conscious mind, and demons of doubt attended him even as he slept.

“If I thought that someone I had passed by on the street had judged me, or if I said hello to my neighbour and he looked away that would play in my head over and over again,” he says. “And I would be asleep dreaming about that.”

In secondary school, Gregg usually hid in the school’s bathrooms, seeking shelter from perceived animosity.

“During break times, I had to lock myself in the bathroom cubicles, because I was afraid that everybody was judging me,” he says. “Because of that then people stopped talking to me, so I became very lonely.”

Research has revealed that individuals with mental disturbances within the schizoid spectrum are prone to developing OCD. Dr Kelleher agrees that the disorders ‘frequently co-occur,’ often causing the ‘schizophrenia-type disorder’ to conceal under an OCD diagnosis.

“The diagnosis of OCD assumes that the individual recognises that the obsessions or compulsions are excessive or irrational. However, some people with OCD can have varying degrees of awareness into the validity of their beliefs,” he says.

“So, say they might reject their obsessions while in the safety of the doctor’s office, but when they find themselves alone in a situation that triggers their obsessions they may be 100% convinced they are fact, which is more akin to a delusion.”

Dr Kelleher says that families should be vigilant for symptoms of paranoia in a loved one who has been diagnosed with OCD.

“If someone is becoming unwell and experiencing paranoia, supporting them in accessing mental health care services to get treatment as soon as possible is key,” he says.

“Effective treatments delivered by a multi-disciplinary team are available, and outcomes are better the sooner they get treatment.” The concurrence of the disorders, in the absence of a dual diagnosis, means living with an incapacitating fixation on cynical thoughts. For Gregg, the miasma of paranoia became so unbearable that he embarked on a journey of self-termination three times, hoping to master a painless suicide technique, using search engines.

My thoughts got so negative that life became very overwhelming. Some days it would get very dark that I couldn’t look after yourself, so I wouldn’t be having showers, or I wouldn’t be washing my teeth and stuff.

A growing number of people turn to Google when they are feeling suicidal. There is scant data available to precisely assess the impact of the search engine’s response to suicide-related queries on dissuading people from taking their lives.

Gregg was hospitalised each time he was contemplating suicide, going to the edge but never falling off.

As soon as diagnosed and set on the road to recovery, he began to pursue an education by enrolling in a mental health course offered by The National Learning Network (NLN). The NLN purveys employment and training for individuals with a wide range of physical and mental disabilities.

Gregg is involved in politics, he publicly rebukes mental health budget cuts and used to be a member of Ireland’s Socialist Party. He is also the founder of a chain of Suicide Prevention groups on Facebook, with Action for Suicide Prevention Cork being its first followed by similar groups for Dublin and Tipperary.

“I set up these pages two years ago because I like activism, I like campaigning,” he says. “So, I thought I might as well give it a go.” He says although society has become more accepting of people who have depression, chronic mental health issues are still taboo topics in Ireland.

“That’s a positive thing that people are now so openly talking about being depressed, but when it comes to life-long debilitating mental illnesses, I think we still have a way to go,” he says.

“You would often hear people saying negative things about schizophrenia or bipolar.” Gregg still experiences psychotic episodes, with his mind floating between the uncertainty of delusions and equanimity of facts. However, he sounds serenely confident when he talks about his incremental recovery, his dreams of going to UCC one day, and his plans of inspiring hope in people with a despair-inducing mental disorder.

“Don’t give up, try to know that you have a lot of worth and value, I know that’s easier said though, I know that from personal experience,” he says. “But know that there is support out there, and it’s just the matter of finding the right support for you.”

If you or someone you know is affected by any of the issues raised in this article, you can get help by phoning the free Pieta House 24-hour suicide helpline on 1800 247 247 or, alternatively, by phoning the Samaritans at Freephone 116123.