This project was funded in part by support from the Fund for Investigative Journalism.
John Creamer has just one question.
“Can you tell I’m on medication?”
It’s a heartbreaking ask and impossible to answer for someone who did not know Creamer before his illness.
Sweet, shy and very low key—whether by nature or the antipsychotic medication—like many people with serious mental illness, Creamer is extremely bright. Originally an English major, he pursued his doctorate in Japanese medieval literature at Yale University so he could study with a particular scholar he admired, and with the hope that an unusual specialty would make it easier to find work.
After graduation, he landed a job teaching premodern Japanese language and literature in the School of International Letters and Cultures at Arizona State University, but things went bad, possibly because of his deteriorating mental condition, and Creamer lost his job.
Creamer packed his bags for Japan and, looking back, now understands that he had a psychotic episode while he was there.
A place that should know better
Arnold v. Sarn, a class action lawsuit that called for services for people with serious mental illness regardless of cost, celebrates its fortieth birthday this year. The litigation ended in 2014 with a settlement agreement that largely replaced “shall” with “may,” encouraging the system to try its best while softening requirements, and permanently doing away with a court monitor—the…
“I was in and out of psychosis thinking that people were stalking me, that I was being stalked by a cult. I thought that I was going to get married to a princess.”
Creamer left Japan, traveling to Chicago and Massachusetts, where he says he was placed in mental hospitals by police, and eventually back to Phoenix, where he was arrested on aggravated assault charges after hitting a neighbor’s house with a rock. He thought the neighbor’s dog was a robot controlled by the CIA or Chinese intelligence.
In jail, Creamer thought someone was spying on him through the toilet in his cell.
“So I was yelling into the toilet and I was put into the hole, which is solitary confinement,” he says. “It was really bad. I got really psychotic there.”
Eventually, Creamer’s brother, Robert, intervened, hiring lawyers and getting guardianship of John. John got out of jail and into treatment. There’s no cure for schizophrenia, but he’s better. He credits the injectable antipsychotic medication he takes for finally making a difference.
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Without the intervention of civil lawyer Josh Mozell and, later, criminal attorney Holly Gieszl, Robert says, there would likely have been no hope for a happy ending.
“He would be dead or in prison,” Robert says of his brother. “There were many times I feared for his life given his delusions, his situation, and what seemed like an impossible task to get him the treatment he needed.”
For most people, a serious mental illness (SMI) like schizophrenia first appears in early adulthood, in the late teens or early 20s for men and a little later for women.
There are exceptions. John Creamer experienced his first psychotic episode in his late 40s.
A diagnosis of serious mental illness will often fall under one of several categories.
Schizophrenia, as defined by the Mayo Clinic, is a mental health condition in which people “interpret reality abnormally.” Symptoms typically include “some combination of hallucinations, delusions, and extremely disordered thinking and behavior that impairs daily functioning, and can be disabling.”
Again from Mayo, bipolar disorder, once called manic depression, is marked by extreme swings in mood, from high (manic) to low (depressed).
Schizoaffective disorder involves symptoms of schizophrenia accompanied by mood disorder symptoms. It’s often described as a combination of schizophrenia and bipolar, a simplistic definition that is only sometimes true.
Major depression can also be diagnosed as a serious mental illness.
Ultimately, diagnosis can be a guessing game.
“Medicine is an inexact science, but psychiatry is particularly so,” Esmé Weijun Wang writes in her New York Times bestselling essay collection, “The Collected Schizophrenias.”
“There is no blood test, no genetic marker to determine beyond a shadow of a doubt that someone is schizophrenic, and schizophrenia itself is nothing more or less than a constellation of symptoms that have frequently been observed in tandem.”
Wang, a graduate of Stanford University, has been diagnosed with schizoaffective disorder. She’s an accomplished author of both fiction and non-fiction. This book of essays has brought her acclaim for demystifying serious mental illness.
She’s correct that there’s not much certainty about a scientific diagnosis, but researchers are getting closer, and have identified a genetic marker that increases one’s likelihood of developing schizophrenia.
One of the most confounding things about SMI is that patients often don’t understand they are sick, a condition called anosognosia.
Creamer acknowledges that stigma also played a role in his resistance to the diagnosis of schizophrenia. He remembers growing up with an aunt with schizophrenia. A poet, she did not have a good life, Creamer says.
“I did have a prejudice against mental illness. Because my aunt was schizophrenic and I felt like she couldn’t function in society, but I think there are different gradations of mental illness and that if you think something’s off, then definitely go and get help, go to a psychiatrist because it’s not like a death sentence.”
In early June, John offered a tour of his group home in west Phoenix, a stuccoed tract home different than his own house, which was designed by renowned midcentury architect Ralph Haver in the Arcadia neighborhood near Camelback Mountain. John’s room at the group home was clean and spare with a library cart packed with Japanese texts in the corner.
It wasn’t easy to be quarantined in 2020. John finished several jigsaw puzzles on his own.
Creamer is still trying to understand what happened. He talks about it in therapy.
“I’m going through it. I’m journaling, you know, it’s been a year, but that’s not been that long to come to terms with, you know, the diagnosis. It’s huge.”
June marked Creamer’s one-year anniversary in the group home. He hopes to be released from probation by the end of 2021 and ultimately return to his home in Arcadia. He’s working on his resume with assistance from supported employment services as part of his mental health treatment.
He is grateful for the injectable antipsychotic medication he receives, but Creamer doesn’t like how it makes him feel.
“The medication makes my face feel numb and I don’t feel as sharp as I used to be,” he wrote in a recent email to AZCIR, and he seems to be tired when he gets the injection.
“But my doctor says it’s just that I’m resentful about getting an injection. Which is true, I do feel resentful, but I also feel like I don’t have as much energy as I used to. I also sometimes get a shaky hand when I try to pick things up and when I’m typing. Also, I sometimes take a deep breath involuntarily through my nose like I’m not getting enough air.”
Creamer hopes to educate others about serious mental illness, including pointing out the system’s flaws.
“I’m not sure exactly how things can change for the better. I know that someone shouldn’t go through what I went through.”