Joseph Peragine is a 35-year-old Italian-American living in Brick, New Jersey. He is a musician and a writer. As a product of these talents, Joseph recorded an album and published an autobiography based on journals he has kept since childhood. See more about this on his website.
As a young adult, Joseph was diagnosed with paranoid schizophrenia. However, he began to experience symptoms during his childhood and teenage years. Joseph describes his childhood self as happy and hyperactive; this hyperactivity caused some to even suggest that he might need medication for ADHD. His dad recognized the hyperactivity as something typical of most children, and encouraged Joseph to participate in sports and other activities where his energy could be utilized. This worked for a while, but as time passed, sports no longer held his full interest. Instead, Joseph began to play guitar.
These years also marked the start of puberty for Joseph, and with this, intensified symptoms. Looking back, Joseph states that he had actually been experiencing symptoms for much of his younger life. These were small things, though, that did not leave lasting impressions. Symptoms included auditory and visual hallucinations, feeling intensely deep emotions and sensitivity, and seeing colors or images from his childhood bed. At the time, he did not experience fear when his symptoms emerged. He also comments that as a child, he did not have the self-knowledge or capabilities of expression to communicate such experiences.
Joseph: But as I started to hit my teenage years and I started going through puberty, my symptoms of my schizophrenia—I was unaware that I had schizophrenia at the time, but the symptoms of my schizophrenia started becoming more intense. And now looking back, being thirty-five years old and looking back at my entire life and trying to remember things, I’ve been experiencing symptoms and hallucinations and things like that my entire life. Like ever since I was a little kid. But when I was a little kid, they were kind of just little, like, auditory things and little things that I would see, but they really wouldn’t be too intense or long—make a long-lasting impression on my mind.
The passing of time meant intensified symptoms for Joseph. Symptoms became clearer when considering the paranoia surrounding his relationships. He thought his girlfriend was cheating on him or his best friend was stabbing him in the back. Outward manifestations of his symptoms increased as others noticed him lashing out. Due to this paranoia and related psychotic episodes, individuals “alienated” Joseph, and he began to feel isolated. As his “loner” status grew, he became more deeply entwined in the “delusional world” inside his head. Rather than being restricted to only those he was in close relationship with, Joseph became paranoid that every person he came into contact with was a part of a conspiracy against him. By the time he was 19, delusions morphed into those of grandeur.
His parents thought he could have been experiencing things that any “defiant” teenager would experience. After he began to lash out, however, the dark intensity increased, and soon, individuals began to tell Joseph that he “needed help.” His parents tried to get him to see a psychologist, and for a short time, he did. After a few months, however, Joseph elected to forego help, and decided that he would be fine on his own. Joseph began to cut himself, which allowed him to refocus his attention away from the thoughts in his head.
Joseph: I was a cutter. I used to cut myself a lot. I used to—I used to—because my logic the whole time was, with my self-mutilation and everything like that, was that—you know, the thoughts in my head were so chaotic, so—I mean, I was suffering. So anything that I could do to focus—to refocus my attention onto something else to get me away from the thoughts that were in my head, that’s what I did. So I would cut myself and things like that, because the pain, the intense pain that I would feel would refocus my attention away from my thoughts. Even if it was only temporary, like the pain would make me relax, [laughs] if that makes any sense.
Eventually, Joseph reached a point of suicidality. Naked and in a delusional state, Joseph attempted suicide, not fully realizing what he was doing at the time. He now recalls being on the highway and thinking that he was on the wrong side of the road. Delusions caused him to believe that there were spirits and forces he needed to face in order to save the world, and that this could be achieved by going through a car and crossing into a parallel universe. In reality, Joseph’s car crashed and he dropped from the road into trees.
Hear Joseph’s description of the suicide attempt:
Following this incident, Joseph was admitted to an institution. He first learned about mental illness at this institution. It was also where Joseph saw his diagnosis written for the first time; the doctor penned “schizophrenia” during the initial assessment. He did not know what the term meant, and was afraid that he would be “locked up” for life. Due to this fear, Joseph tried to change his story to get released from the facility. He began to describe depression and suicidality, and as a result, the doctor misdiagnosed him with bipolar disorder.
Joseph: I was in an institution, and when I was in the institution I saw the doctor write “schizophrenia” down on paper when I was being interviewed or evaluated, whatever it was. At that point, that was the first time I had seen that word and I didn’t know what it was, and I was very terrified and I thought that I was going to get locked up for life because I didn’t know what it was or anything like that. So I changed my story to get out of the institution… and they actually misdiagnosed me as bipolar.
Eventually, he received the correct diagnosis of paranoid schizophrenia, and Joseph began treatment in 2001. By this time, he was in his twenties. During therapy, Joseph came to realize one of his symptoms: hearing voices. This was something he had encountered for many years, but treatment came with the realization that this was a symptom. Joseph describes “hearing voices” as, at first, like having a song in one’s head. While this may seem like something that everyone experiences, he notes that for individuals with schizophrenia, there is a lack of control over what is being heard. For example, it may begin as seeming like a song that he has heard many times before, but suddenly the words change without his control. At night, he would also hear distant noises that sounded like a large crowd, which culminated in questions directed at him specifically. As he got older, his mind began to hear voices of people around him. As this continued, the voices became offensive, telling Joseph that he would never amount to anything and that he was a horrible person. Things in Joseph’s mind began to blur, to the point that he believed that the physical people around him were truly thinking what the voices in his head were saying. As a response, he began to lash out at others, which added fuel to the fire of his hallucinations and delusions.
Experiencing hallucinations and delusions contributed to Joseph building defense mechanisms. Even though the outward expressions of these symptoms may have appeared hateful or violent, Joseph states that these were done in self-defense; deep down, he was the same as he always had been. His true character remained, and even when he lashed out or got in fights, inside, he continued “fighting for the right of good.”
Joseph explains his self-defense here:
Even if Joseph knew his true character and experiences, others often only saw the outward manifestations of his symptoms. Some people called him crazy. This upset Joseph, as at the time he was insecure about what others thought of him, especially if it was clear that they believed something to be wrong with him. He recognizes now that his peers likely did not have the ability to fully comprehend what Joseph was experiencing, in part due to being wrapped up in their own lives and choices. Thus, rather than receiving support from his teenage acquaintances and friends, he felt like an outcast.
Additionally, this lack of support might have been, in part, from a lack of awareness of mental health issues at the time. Mental illness was not something that was largely discussed at the time (1990s and early 2000s), both within Joseph’s circle of family and friends and the general public. Perhaps due to this lack of discussion and awareness in his earlier years, Joseph now desires to talk about mental illness openly and work to increase others’ levels of awareness. Joseph’s method of doing this begins with interaction with others. He typically waits to disclose his diagnosis with someone new until after conversation and becoming acquainted. If the interaction feels comfortable and the direction of the conversation feels natural, he will share about his experiences with paranoid schizophrenia. When this disclosure occurs, people are often interested in learning about mental illness. Frequently, they do not possess in-depth knowledge of the topic due to limited previous conversations or education. Joseph approaches conversation and awareness in this way because he believes dialogue occurs if he and the other individual share experiences and interests. Shared experiences provide Joseph with the space and capability to engage in conversation and provide education to increase awareness.
In addition to lack of knowledge about mental illness, stigma tied to mental illness also serves as a barrier to engagement and understanding. According to Joseph, stigma can come from multiple sources. For instance, movies and television shows seem to “glorify” schizophrenia, or news stories link atrocities to mental illness or schizophrenia specifically. In turn, individuals may begin to assume that those committing terrible acts must always have a mental illness. Thus, many tend to associate “schizophrenia” with negative beliefs or connotations.
Joseph feels as if stigma surrounding mental illness can be broken down if the educational aspect comes from someone who is calm and mellow. For his part in combating this, he works to present himself in a positive way. He is hopeful that with the increased and improved treatments that help individuals with schizophrenia live high-functioning lives, there will be a decline in the stigma around schizophrenia and mental illness as a whole. While this can occur through face-to-face conversation, Joseph also combats stigma and misunderstanding through his musical and written work (http://www.josephaperagine.com).
Listen to Joseph describe stigma here:
Getting to the point of working against stigma and engaging others in positive interactions did not come without persistence and hard work. Joseph has been in treatment for 16 years and includes therapy as well as medication. At the start of treatment, his psychologist would identify Joseph’s triggers, which were the things that increased his hallucinations and delusions. After identification of triggers, Joseph would “baby step” into them; if it became too much to handle, he would step back. Each session, he would step further into his triggers, with the end result being desensitization to the things that made him “sick.” Indeed, Joseph was eventually able to overcome the majority of triggers that caused his symptoms. When this began happening, his doctors encouraged him to explore his creativity, which resulted in writing and making music. He started journaling and creating music about his experiences. At first, doing so caused Joseph to become upset as he re-experienced the past through his creative projects. Now, however, experiencing such things repeatedly causes desensitization. Joseph does not create for his benefit only, but for others as well. When others encounter his work with a positive reaction, deep conversation can follow. This causes Joseph to feel a connection with the people around him, and he feels as if others are accepting him into a world that he once thought he would never be accepted into.
Joseph: It creates a meaningful connection with me and people around me, and when that happens, it makes me feel like I’m at the—at one time the world that outcasted me and didn’t understand me, one by one the people that I present my stuff to, I feel like they’re accepting me in the world that at one time I thought would never accept me. And that feeling of positivity and connecting with people and making those meaningful connections, it became addicting because it made me feel better about myself and my own situation. The more I did that and the more positive feedback and reaction I got out of it, the more I wanted to do it.
Positive connections with others encourage Joseph to continue creating. Creation allows him to refocus his “manic energy” into music, writing, and other activities that work toward a positive goal. Joseph also perseveres due to the value he places on open dialogue about feelings and experiences; he says that an important part of having schizophrenia is the need to discuss experiences so that others may become aware. In this way, Joseph experiences a sense of purpose and accomplishment; he feels as if he is helping not only himself, but others.
A typical day for Joseph begins with coffee. Then, he works a nine to five shift as a lab technician, where he interacts with others, works on projects, and meets deadlines. In the evening, he makes dinner and spends time with his girlfriend. He describes himself and his girlfriend as “foodies.” He spends some evenings writing or recording music or journaling. Schizophrenia is always on Joseph’s mind, and interwoven in the day-to-day is Joseph’s view that recovery is an ongoing, daily process; he has accepted the fact that he will be taking medication for the rest of his life, and that the upcoming years could be a “fight.”
While many of his days are good, Joseph is quick to point out that there are bad days mixed in. Sometimes he may not feel well and he will experience hallucinations. Other times, his anxiety feels heavy, which causes the need for him to “step back.” If he is at work and a visual or auditory hallucination begins, he might take a sick day and go home. This is one tool that he has learned to use in addressing such situations. Often, the most important tools are self-awareness and knowledge to recognize when something is “off.” For instance, he has noticed that if he lacks an adequate amount of sleep, he may become symptomatic. Therefore, Joseph places great value on a structured routine that includes specific sleep, work, and relaxed time. Routine helps him stay well, and too much deviation can cause him to become symptomatic. Joseph compares this balance of routine and the unexpected to detective work, where he must assess what is going on and decide how to best handle the situation.
To maintain his daily structure and refocus his energy requires great concentration and effort on Joseph’s part. He says that hallucinations are never really gone; they are present but masked by medication. Persistent hallucinations, paired with the required concentration, can become exhausting. This exhaustion does not stop Joseph, however, and he is strengthened by the positive and meaningful connections he has made with others, as well as his efforts to help the world understand mental illness. Joseph’s positive outlook on life is an additional source of his strength.
Joseph also receives support from his family, and the positivity from them and his girlfriend encourages him to also remain positive. They place value on finding humor in situations, even tough situations. Joseph recalls a time when a lunar eclipse was supposed to happen, and his mother called him ahead of time to tell him that if he saw that, it would be real and not a hallucination. This is just one example of the way that his family values laughter and humor in their desire to demonstrate and share positivity.
Joseph talks about the importance of positivity and humor here:
Joseph says he would not change much about his life. Without schizophrenia, he would not be the person he is today. He believes a diagnosis of schizophrenia has humbled him and created a deeper appreciation for life and its moments.
Joseph: I don’t think I would change it. Now that I have it under control, I don’t know. I don’t mind. [laughs] Because it doesn’t get in the way of my life anymore. I wouldn’t be who I am. I wouldn’t be the person that I am. I wouldn’t have my personality. I would be a different person and I wouldn’t know who that person would be. Would it be a bad person? Would it be a good person? Would it be a—you know, I have no idea. I don’t really tend to think about those things because you get whatever life throws at you, and whatever life throws at you, you have to make the best of it. I’m just making the best of it and like I said, it could be a lot worse. I really don’t think there’s anything I would change.
Joseph enjoyed sharing with The Schizophrenia Oral History Project. When he talks about his experiences, he feels better.
I’m just like, a normal guy trying to get through my day to day, just like you are. I have the same fears and unanswered questions in life that you have, and I’m just trying to survive like everybody else. There’s nothing different about me. I’m not a killer. I’m not like a multiple—I’m not like—I’m not harmful to society. I’m just an everyday person trying to live my life like you are.
Hear Joseph’s message here: