Recommended Reading: An Excerpt from Beyond Crazy

Schizophrenia Update, December 2002

New Book: "Beyond Crazy" by Julia Nunes and Scott
Simmie, published by McClelland & Stewart. Sept 2002
ISBN 0-7710-8068-9 $34.99 Canadian dollars

Toronto Star October 1, 2002
LENGTH: 1414 words

No looking back

By Julia Nunes and Scott Simmie

With the help of her mom, an indomitable young woman tames a terror from the past
This is a tale of two generations. It's a sad story that leads to a much happier one. And it begins in 1980, in the small Northern Ontario city of Sault Ste. Marie. Terry-Lee Marttinen is 16 years old, dating a young man named John (a pseudonym) when she discovers she's pregnant. Something equally unexpected is happening to John. His behaviour has become increasingly bizarre: he's smoking marijuana, dabbling in the occult. Terry-Lee is scared; she stops seeing him.
Over the next four years, John winds up in and out of hospital. Much later - too late - doctors determine he's been suffering from schizophrenia.
One summer day in 1984, when his daughter Tara is 3, John succeeds after several attempts at suicide. He is 22 years old.
About a decade later, another young life is entering those delicate teen years. And Tara Marttinen is herself beginning to feel different. To the outside world, nothing is seriously wrong. After all, what teenager doesn't stay up late or let their grades slip slightly?
Then one day as she sits at her desk in class, he hears, for the first time ever, a voice in her head. "It was out of the blue. I heard: 'Take off your shoes and sit under your chair.' Really loud, sort of screaming in my ear."
For the next several months she carries on with her classes, her meals with her mom, and nights out with friends as if nothing's wrong. She shares her secret with no one. But late at night, she lies awake for hours, lost in a jumble of racing thoughts.
At 16, partway through Grade 11, Tara finally "spills the beans" to her mother. And immediately, Terry-Lee thinks of schizophrenia. "When she told me she was hearing voices, I knew instantly. Just instantly. My little back went up and I was instantly fearful."
We meet Terry-Lee and Tara at a cafe in downtown Toronto. It's the start of a mini-vacation they've been planning for weeks. Together, they're visiting relatives, taking in the sights, and "shopping, shopping, shopping."
Mother and daughter have matching blond hair, blue-grey eyes, and friendly smiles. When one speaks, the other nods; often, they finish each other's sentences.
"We've been together a long time," Terry-Lee says proudly. "Just me and her. Being a young single mom, I think Tara and I have been really close."
Tara nods in agreement. "I actually like hanging out with my mom. ... It's relaxing to be around someone who understands you." Tara is wafer-thin with finely carved cheekbones, alabaster skin, and a small silver hoop through her left eyebrow just above her funky black eyeglasses.
"We're very lucky," she says. "I'm very lucky."
Tara and Terry-Lee want to share the story of what's made them lucky. Of how they got from there to here. There was Tara sitting alone in her room, writing page after page of anguished poetry. Here is Tara finishing high school with honours, Terry-Lee preparing to send her off to university. "I'm relieved," Terry-Lee says. "I was so scared. And now I know it's okay. I have a safe feeling inside."
The one thing Terry-Lee knew when she found out about the voices was that Tara needed help away from home. "I just made the assumption that the care wouldn't be any good in the Soo because of Tara's father's care."
With a phone call to a distant uncle who worked in the mental health field, Terry-Lee arranged an appointment at a clinic in London, Ont., seven hours away by bus. They didn't know it at the time, but what they'd stumbled into was a leading-edge treatment facility for first-episode psychosis. Dr. Ashok Malla runs the Prevention and Early Intervention Program for Psychoses, or PEPP. Soon they were sitting in his office as he led them through a clinical assessment.
Straight away, Dr. Malla recognized the early signs of psychosis. Before he'd even diagnosed Tara with schizophrenia, he prescribed a low dose of an atypical antipsychotic medication. "If we see symptoms, if they've been there for more than a week, we treat them," Dr. Malla says.
Tara was also given a brain scan in a magnetic resonance imaging machine. "That was the scariest thing," she says. "But I just had this feeling: After this it's going to be better."
Tara was never hospitalized, never needed to be. Instead, she and Terry-Lee returned home and went on with their lives.
Slowly, the voices faded away. But other challenges remained. Schoolwork was harder than it had been, and even hanging out with friends could be exhausting. "I missed, on average, one day a week out of school. ... I'd be wiped out. There was too much going on."
Tara was tackling head-on the kind of life changes none of her friends were interested in making. Late-night partying gave way to quieter activities: jewellery-making, journal-writing, embroidery. The junk food was tossed - no more Cheez Whiz sandwiches - and replaced with a high-protein, low-sugar diet bolstered with vitamins. (Terry-Lee had done the research on
the Internet.)
Twice a year, mother and daughter made the long trip to London for consultations with Dr. Malla.
If all this sounds simple, it hasn't been, as Tara wrote in a PEPP newsletter: "I can't for even one day (diverge) from my regimen of taking my vitamins, going through my day free of over-stimulation, then taking my medication, and finally, going to bed at a decent hour. If one of these elements were missing it would have drastic effects on my performance the next day."
The payoff, however, has been huge. In five years, Tara has never had a relapse. "I know when something's wrong," she says, "and when I should rest."
Dr. Malla is thrilled with Tara's progress. "She has a vision of her life," he says, "of what she wants to do."
What Tara wanted to do, after high school, was go to university. In Sault Ste. Marie, that meant leaving home. "We're trying to be realistic," Terry-Lee says. "Do the homework, cover the bases, and then leap off the cliff."
The homework included choosing university in London, where Dr. Malla is. Tara worked for a year after high school to save money. She applied for student loans, and won scholarships to help pay for tuition and books. And she decided against a room in residence - "too chaotic, too much going on," says Tara.
Today, the results of all that can be found on a secluded street in a clean and cozy apartment in an old house. This is Tara's new home, the start of her new life. "I like living on my own right now," she says. "It's very comfortable. It's my own space."
Tara is pacing herself carefully. Taking three classes (English literature, calculus, psychology) instead of a full course load of five. Keeping the usual first-year socializing to a minimum. "I'm a loner anyway," she says with a self-deprecating laugh.
In her mind's eye, she carries a picture of the future. A four-year honours degree in psychology completed over five years, including summer classes and a full course load in the final year. After that, a career counselling teens with mental health issues. Even further down the road, she foresees marriage and kids, and perhaps a chance to be medication-free. "If for some reason my brain's sort-of levelled out again ... I don't want to be on meds and having kids."
But for now, she's focused on school. She says she's not even looking for a boyfriend. "I don't want to be with a person who doesn't respect my illness and understand the importance of it," she says firmly. "It's a big part of my life. I don't want it to be, but it is. It's something I have to deal
with, and they would, too, as a result of being with me. ... And I don't think right now anybody's prepared for that."
Back at the cafe table, Terry-Lee shakes her head, amazed. "She's wise. She freaks me out. But I understand why she's wise. Tara's spent more time thinking about the meaning of life than most people do in a lifetime."
Tara, slightly embarrassed, allows that she has "grown up fast." But she finishes her thought in a way that reminds us she isn't too grown-up just yet. "It's like you're sixteen," she says, "and suddenly feel thirty, you know?"
Because the comment draws laughter from the rest of us at the table, Tara - ever considerate - adds: "Forty, eighty, whatever. More like eighty." Then, discreetly, she smiles.

Tara Marttinen is now in her second year of university. This is a condensed excerpt from the book "Beyond Crazy"
by Julia Nunes and Scott Simmie,
McClelland & Stewart. ISBN 0-7710-8068-9



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