Three diagnoses, three survivors

One lives with his parents, and two are now advocates in the mental-health field.

People survive schizophrenia, but recovery is a hard and often lonely road.

Studies indicate that about a third of people make a full recovery, a third show improvement, and a third remain seriously ill.

Here are three stories of three survivors.

Like everyone, Gerry Maskarinec has good days and bad ones.

Diagnosed with schizophrenia more than 25 years ago, Gerry, now 48, lives with his parents, Gabe and Barbara Maskarinec, and takes medication four times a day to treat his mental illness.

During high school, he was considered bright, insightful and artistic. He had the lead role in a production of "You're a Good Man, Charlie Brown." After school, he worked as a lighting technician at the Idaho Falls Civic Auditorium.

But things started going wrong his senior year. Frequently, he would sit in the hall at Idaho Falls High School playing his guitar or flute. Gerry graduated and went on to college, but at the end of his freshman year there was an episode in which he believed he was involved in a fire.

His parents wondered where to find help. In 1985, they sent him to the Menninger Clinic in Topeka, Kan., considered one of the nation's best psychiatric hospitals. But there's only so long a person can stay hospitalized and only so much a family can afford.

Gerry spent time in shelter and group homes, but unsatisfied with the conditions, the Maskarinecs took their son back into their home in 1988.

"People talk about 'tough love' and all that, but you wouldn't send your kid out of the house if he had cancer," Barbara said.

Gerry spends his days volunteering with his mother at the Museum of Idaho and visits Hastings Books Video and Music, near his home. He still plays his guitar and flute, frequently performing for family members.

He recognizes the need to take his meds, but his father concedes he probably wouldn't remember to take them if he lived by himself.

Barbara and Gabe know they won't be around forever, and that Gerry eventually will become someone else's responsibility.

Still, love asks no questions and doesn't complain.

"As long as we're able to care for him, we will," Barbara said. "By making his life better, it makes ours a little better."

Rick Huber of Twin Falls, now one of Idaho's leading mental health advocates, was diagnosed with schizophrenia in 1982.

Over 25 years, he has learned to cope without medication, mainly by learning there are patterns of thinking he needs to avoid or he'll be back on the roller coaster.

Now 46, Huber serves as an advisory member of the National Alliance on Mental Illness and is a State Hospital South adviser. He recognizes the challenge others like him face.

"When I first start going into an episode, it's very euphoric," Huber said. "I feel like Superman. I stay up for several days. Eventually I start having visual hallucinations. And even though it starts out benign, even religious, it turns hellish."

The euphoria schizophrenia produces is a hard thing to shake, and he can understand why a person might crave it.

"To me, the biggest key for people getting better is realizing it's not good for them. They have to say, 'No matter how good it feels, it's not good for me.'"

Martha Ekhoff, of the Boise-based Mountain States Group, suffered for years from psychotic depression. She is now the director of the nonprofit's office of consumer affairs and an advocate for treatment that addresses the patient's strengths as well as the symptoms of illness.

She said one of the biggest barriers to helping those diagnosed with mental illnesses is our culture's attitude toward them.

"Mental illness is not regarded as seriously as other illness," she said. "If you walked into a hospital and were complaining of chest pains, you'd get instant attention. If you walk in with a mental health problem, you'll sit there for four or five hours while they decide to call someone down. Nobody will talk to you, and if you try to get someone's attention, security will show you to the door."

She understands how someone with schizophrenia might prefer fantasy to reality.

Reality for them often involves being treated like a semi-invalid, working at a menial job, being told where to live and taking medications that cause all sorts of side effects.

"With psychotropic medication, if there are 15 side effects listed, you can be sure you're going to get at least 10 of them," she said. "How would you like to walk around with your eyes blurry all the time, or you're drooling, or you're moving slow and you know you're moving slow?"

Ekhoff counts herself as one of the lucky ones. Her mental illness cleared away, but not after many humiliating incidents.

"People are marginalized," she said. "I had to go to the county every month to see if they would fund my medication. The woman in the window would shove the clipboard at me without even looking at me. Nobody ever called me by my name."

Craig's daily meds

Here is a list of Craig Tanner's daily medications, taken from the card in his apartment the week of Aug. 5. Not every one is psychotropic, but it might have been prescribed to offset the side effects of the psychotropic drugs prescribed for his schizophrenia.

CLOZAPINE (100 mg): Also called Clozari, this drug is intended for use in patients with severe schizophrenia who have not responded to any other anti-psychotic drug. Clozapine is also used in patients with severe schizophrenia when other anti-psychotic medications have caused intolerable side effects. How anti-psychotic drugs work is not completely understood. The effect of clozapine is believed to be related to its actions in blocking the neurotransmitters dopamine and serotonin in a region of the brain called the limbic system, which is involved with emotions and motivation. The drug is not without problems. Clozapine is generally considered the most toxic of the anti-psychotic drugs. It causes agranulocytosis, a life-threatening depletion of white blood cells, in 1 percent to 2 percent of patients. It also causes epileptic seizures and adverse effects on the heart and blood pressure more frequently than other anti-psychotic medicines.

LITHIUM ER (300 mg): Lithium is commonly used to treat mania and bipolar depression. The way lithium works in the body is unclear, but its therapeutic benefits are probably related to its effects on other electrolytes such as sodium, potassium, magnesium and calcium.

BENZTROPHINE (twice a day, 1 mg and 2 mg): Benztrophine is used to treat a group of side effects (called Parkinsonian side effects) that include tremors, difficulty walking and slack muscle tone. These side effects may occur in patients who are taking anti-psychotic medications used to treat mental disorders such as schizophrenia.

RISPERDAL (shot every two weeks): Also called risperidone, this is chemically unrelated to the older anti-psychotic drugs. Also, unlike older anti-psychotic drugs that primarily inhibit the actions of dopamine, a chemical in the brain, risperidone may also have some action against another brain chemical, serotonin. The proper level of both dopamine and serotonin are influential in maintaining mental well-being. An advantage of using risperidone over one of the older anti-psychotic drugs is a lower incidence of Parkinsonian-like side effects. Also, some patients who showed little improvement with older anti-psychotic drugs respond better to risperidone.

RANITIDINE (150 mg): Ranitidine is used to treat and prevent ulcers in the stomach and intestines. It also treats conditions in which the stomach produces too much acid and other conditions in which acid backs up from the stomach into the esophagus, causing heartburn.

DOCUSATE (100 mg): A laxative and stool softener, sold in the United States under multiple brand names.