Dear Dr. Bonnie,

I’m a 20-year old guy and I keep seeing a woman, and as crazy as this may sound, nobody else can see her. She is often like at the corner of my eye, but sometimes I can see her and she will just stand there staring at me, I know this sounds weird but it’s true. If I can’t see her, I can feel her just watching me. I also hear noises, but it’s not like people, I hear screams and footsteps that nobody else can hear. I am scared to go out; literally scared, I think people are always staring at me and are thinking bad things and saying stuff behind my back. I sometimes feel like I want to kill myself I just want to die, I have gone out a couple of times looking for a place to kill myself. But something always changes my mind; I know that I will end up killing myself one day. I feel as if pictures can actually look at me so I have to put them down, I also feel as if people can read my mind and that they are all plotting against me. I hate virtually everyone. I like to hit my brother and sister. I know I shouldn’t as they are trying to be nice but I can’t stop. I tried counseling but it actually didn’t work and I felt way worse. Please help!


Dear Distressed,

First of all, I want to tell you that I am so glad you are reaching out for help.  People who have experiences like you are often too afraid or mistrusting to look for help.  The fact that you are reaching out means that you have courage and some insight into your problems.  This means that you are in the best position to respond to help. 

Based on what you have written, I am very concerned about you and worried that you will take your own life.  It is very important that you seek professional help immediately and let people know when you are having thoughts of harming yourself and are honest with them about your other experiences.  You can be helped and you will feel better!  But you will need professional help and medicine.

What you are experiencing sounds frightening and isolating.  People, who have experiences like yours, are at a higher risk for suicide. You may question whom you can trust.  You may even distrust the people who love you the most and are trying their hardest to help you.  Allow them to help you.  The medicine can help you to see things more clearly.  Take it!  If the medicine isn’t helping, tell your psychiatrist, and he or she can find something different.  You are not the only person who has these sorts of experiences.  There are thousands of other people who suffer similarly, and many of them are able to find peace and lead functional lives through the use of medication and other supports.  You are burdened with a serious illness, just as someone who is burdened with diabetes or another major illness.  Having diabetes for example does not mean that your life is over or not worth living; it just means that you need to take extra steps to taking care of yourself. 

The way in which you talk about your experience of the woman and the sounds you hear, feeling looked at by pictures, fearing people can read your mind, and the general suspicions of others is very similar to the experience of many, many other people who have been diagnosed with schizophrenia, paranoid-type, or possibly bipolar disorder.   

The fact that you can write so articulately about your experience, and the fact that you are reaching out for help, means that your prognosis (i.e. predicted outcome) is good.  That  is not just my personal opinion, but it is based on research.  There are thousands and thousands of other people like you, who have gotten better and are leading a good life. Most of them still struggle in some ways, but they are able to manage it.   You have an illness that you will always have to pay attention to and take care of.  That is the burden you will have to carry.  But if you seek and accept help, and have hope, you can have a rich life with all the joys and miseries that are a part of the human experience.   

But you need to act. You are 20 years old, which is around the age in which this disease usually fully manifests itself in males.  The research suggests that the earlier you get the correct medicines, the better you will do.  You are currently worried about your mental health, or else you wouldn’t be writing me.  It is a good sign that you are worried.  Act now, before you lose that insight and stop trusting everyone.  Finding the right medicine can take some time. Everybody is different and may require different things.  Be patient with that.  Your psychiatrist should be checking in with you and consulting with you on the effectiveness of the medication, and trying different things if the current medicine isn’t working well.  It sounds like you had a bad experience with counseling.  That may have been because it was a bad match between you and the counselor, or they were using a technique that wasn’t right for you, or you just weren’t ready for counseling at that time, or it was a bad counselor.  With your illness, medicine is the most important thing.  You might later decide  to use counseling with you and your family for further support.  Based on your letter, I would guess that you have the intelligence and insight to respond positively to psychotherapy in addition to medication. 

Get help, take care of yourself, and have hope!  You can have a rich life! 



Dr. Bonnie