Schizophrenics hear voices. It may be a strong indication that the lack of drugs was a factor.
Schizophrenia typically manifests itself at around that age - late teens to early 20's. And it is a horrendous disease that affects the wealthy and the poor and everyone in between.
For several years I worked as a finance manager of a private social work agency. They provided private case management and psychotherapy and ran a group home for schizophrenics among other services like providing hospitals and school systems with social workers (licensed MSW’s) on either a temporary or long term basis.
One of our “clients†was a 40 something year old man who had firsts been diagnosed with schizophrenia in his early 20’s. From what I understood and knew about him, early on in his life, he was very normal and actually exceptionally bright, a promising mathematician and on track to become an aerospace engineer and his parents, who seemed to be good and deeply religious (Jewish) people, and were quite wealthy and loved him dearly.
But his schizophrenia really started manifesting while he was in grad school and his parents had him committed to a private and well known psychiatric hospital several times, but since he had by then reached adulthood, they couldn’t keep him there against his will unless he was posing a real and credible threat to himself or others. As long as he was on his meds and getting counseling and psychiatric care, he was OK, no - not quite normal, but not stark raving mad.
But as his schizophrenia and its delusions and paranoia got worse and worse, he became increasingly non-compliant and preferred living on the streets and homeless and his parents couldn’t do anything about it until he was arrested for threating people or committing petty theft, but even then it was typically a 48-hour hold.
I remember him coming in to get counselling as a condition to get his small allowance, which would have been increased if he only he would agree to living in a group home and taking his meds. But he would comply just enough to get his small allowance and then disappear for weeks or months at a time. And OMG! he stunk to high heaven. I can’t begin to describe the extreme BO he had.
He would come into our office to get his “allowance†that his parents provided in hopes that it would be the carrot as opposed to a stick to get him into a more stable and controlled and safe environment. I’d had interactions with him when his social worker walked him to my office to get his allowance. Sometimes he was charming and engaging and obviously highly intelligent, even sometimes showed empathy like the day he saw me with a walking cast on my ankle due to a severe sprain and asked me about it and wanted to know that I was OK and not in too much pain, but at other times - not so much.
Most others in the office including some of the social workers were afraid of him and didn’t want to have anything to do with him nor be anywhere near him because of his stench and unpredictable.
One day he came in unexpected and knew enough to come to me as he knew I kept the petty cash (and FWIW, my office was outside of the main office and so no one but me knew he was there – not a good security set up in retrospect which was later changed).
He wanted his allowance and when I told him that I couldn’t give it to him unless he saw his social worker first as was the agreement, he freaked out and shouted and then screamed at me and called me the worst names imaginable and threatened to kill me unless I gave him his $20.
But I kept my composure and in my calmest and the most reassuring voice I could muster - what I used to and still, call my “Mister Rogers†voice (which I’ve sometimes found also helpful in dealing with toddlers having a meltdown), I talked him down enough that I could, under the guise of not having the cash in my office, to call for help.
I left that job about a year later and still to this day wonder what ever happened to him. I didn’t see him as a bad or evil person or demon possessed, although sometimes he acted that way, but rather I saw him as being a very sick person. By the Grace of (fill in your deity here) go I (or you or someone you love).
