My wife Michelle sat across from me in the lounge of the psychiatric ward in Fraser Valley, British Columbia. She had brought a duffel bag full of my clothes and toiletries, as well as a jar of homemade juice. “Poison,” I said. Michelle stared at me, her mouth open. “It’s only grape juice. Just drink a little.”

“I can understand why you’d want to do this,” I said, “but I may be useful alive. As a bargaining chip.”

“Bargaining chip? Jan, I don’t know what you’re talking about. I’ll drink it then,” she said, and reached for the cup.

“No!” I grabbed her forearm. She pulled back and tears appeared in her eyes. The cup remained between us. “We just thought you’d appreciate something from home,” she said. I looked at the jar.

Indeed, at our wedding, we had drunk juice made from grapes from her family’s property, canned by her parents. It often appeared at special dinners. But here at the hospital? She could have brought it only for one reason. Michelle and her parents wanted me dead. My suicide attempt of the previous evening had led them to my secrets. They now knew that I had set in motion events that would lead to a great conflagration ending the world, and they wanted me dead to mitigate the coming furore.

I could appreciate their motive. But could I let them poison me? “All right,” I said. “If you really want me to drink this, I will.” I took the cup. I paused with it at my lip for only a moment before drinking. “I’ll just go lie down, now.” Poisoned, I went to my room to lie, fully clothed, atop my bed with hands folded on my chest, a suitable pose for someone about to slip away from the world. I woke up an hour or so later.

Maybe my wife didn’t want me dead? This clarity of thought passed. For the remainder of the day I monitored others in the ward and avoided speaking, lest another person be caught in my horrific bind. In the following days I often sat at the windows in the lounge, positioning myself to give the assassins outside the cleanest possible shot. Sometimes I refused to go to bed, so as to facilitate the efforts of the waiting government agents — much to the exasperation of the nurses. “And why do you think someone wants to shoot you?” they asked. “Because of the book,” I said. “My book.”

My novel had put me in the ward. Before this period, I had no history of mental illness. The only forewarning had come several weeks earlier, when difficulty sleeping had culminated in a sudden, unprecedented fear of flying, which led Michelle and I to cancel a flight to India. That was peculiar, we thought. But not a harbinger of a mental health crisis. I had sold my first novel to an American publisher and all that should have remained was the excitement of publication. But the dread and insomnia I’d experienced before our aborted flight came back, hard, now attached to the book. It was a fantasy novel based on aspects of Hindu mythology. I grew convinced that my depiction of gods and goddesses would anger some Hindus who were already upset with Western depictions of their religion, and the complaints would spiral into a protest that became international and ugly.

Finally, I spent an entire night awake with my thoughts gone wild. As the sick light of day spilt into our living room, I realised that I was an agent of the Hindu god Shiva. My book would be a precursor to international protests culminating in nuclear war. It was time for the destruction of the world, and I served as the catalyst.

I said nothing of this to my wife. In fact, I went to work at the library as if all was normal, except that along with my other things, I packed sleeping pills and a meat knife. Clearly I was evil, and so could redeem myself only by one means.

As I sat at the public desk, taking the pills with little concern about who saw me. I became convinced that government agents had sent police sharpshooters to kill me when I stepped outside. I had planned to kill myself promptly after my shift, on my own, with the double effect of pills and slit wrists. But maybe instead I should go outside and face the waiting ambush? What was the least evil way for someone as evil as I to die? I sat, unsure of the proper decision. I watched the door, certain that the gun-men would grow tired of waiting and storm the library, but eventually it was a coworker who stepped inside and, after speaking with me, called an ambulance.

For the first week in the psychiatric ward, I attempted to appear as sane as possible (apart from tracking assassins) in hopes of discharge. I was successful in my efforts, briefly. A labour dispute hastened the psychiatrist’s decision to discharge me. My wife was more astute.

Again, nightfall revealed my inner state. We lay together on the bed. “You’re not better,” she said. “All that time in the hospital, you were just strategising how to get out.”

“I hated being in that place.”

“Jan.” She closed her eyes. “It’s not just you I’m worried about. If you become delusional again — I don’t know if you’re going to do anything to me.”

I was dumbfounded. How could she think . . .

“Will you let me take you back to the hospital? Please?” I dropped my head. Less than a day after my discharge, I was back. This readmission was causeto reevaluate my condition.

So far, no satisfactory explanation for my state had emerged. I’d listened to a range of speculation as to my condition, from manic-depressive to blossoming schizophrenic. Michelle learnt from a friend’s brother that Lariam, the antimalarial medication that we’d taken before our planned trip to India, could have psychoactive effects, including delusional thinking, and this was added to the mix of possibilities.

Though sometimes I could appreciate how irrational my theories of apocalypse were, I could not resist the downward path of them, and I would go back to my room and invite the person hiding in my closet to come forth to take me away. In some circumstances, I was told, a mood disorder, such as bipolar disorder, or a major depression, can also involve psychosis.

“Psychosis” is a frightening word to hear in association with yourself, recalling the worst of news headlines and popular culture. Psychosis changes the way a person thinks, characterised by a loss of contact with reality that can include hearing voices, hallucinations and a preoccupation with abnormal ideas, such as a feeling that one’s thoughts are being controlled.

Psychosis can happen to anyone, in a sudden or gradual onset, though it often begins between the ages of 16 and 30, and males are more likely to show early signs. I was 29 at the time (I am now 37). In me it was a flamboyant symptom because of the extremes of my paranoid delusions and the actions I had taken. But as for the category of mental illness to which my psychosis belonged? Nobody at this stage would commit to an answer. Resigned to being in the ward, I submitted to the place.

Every evening, the nurses produced our evening medication. During the first week, I’d taken so many pills I thought I would choke on them. Side-effects varied. One antidepressant I was prescribed (after the second opinion on depression) had such a strong sedative effect that sleep felt like settling on the floor of a dark ocean. Surfacing the next morning was onerous and I staggered about during the day in a personal fog. Naturally, I suspected poisoning. An adjustment was made. Once, I had a severe reaction to my antipsychotic that made my muscles cramp and immobilised me; I was wheeled back inside for an injection of benztropine and another change to my prescriptions.

The psychiatrist and I continued to meet in his office, but I don’t feel our conversations amounted to therapy and, anyway, I undermined their usefulness with a continuing desire not to appear overly deranged.

The professional from whose interaction I most benefited was the recreation therapist. She would come every other day with a project — a walk or a collage with old magazines. Distraction was a relief, but more importantly, she was someone to whom my paranoid theories would not stick. I just couldn’t believe that a CIA operative would be so concerned with baking muffins.

My final discharge followed these small gains in rational thought and social interactions. Three weeks had passed since I entered the ward. Now, I left with no precise diagnosis but a prescription for drugs targeting my general symptoms: antidepressant, antianxiety, antipsychotic. That my horrible thoughts might stem from something as mundane as mental illness was highly preferable to being the instigator of the end of the world.

On the other hand, there was the unkind reality of being back in that world with a mental problem of uncertain character and duration. What would we tell people? Would I succumb again to that state of unbound, uncontrollable paranoia?

The grip of delusional thinking eased gradually. Whereas I might find myself star- ing at parked cars on the street with a percolating theory about their drivers in the first few weeks, more prosaic concerns took over after about a month. Then, I would stand in the grocery store fumbling to open a flimsy plastic bag for my apples, while inside me a palpable fear grew that when I got to the cashier, I would be unable to fish the proper coins from my wallet and break down before her.

For many months, I suffered the effect of someone clinically depressed. My movements were slowed — it was a chore to walk to the end of the street. I was prone to crying. My face was slack and lacked animation. In the mornings, when I could sleep no more, I found getting up to be a sad task. Was that my problem? A severe, psychotic depression? My wife, in addition to the other work she did on my behalf, such as earning a living, had learnt my family’s history from relatives in Denmark. Indeed, there was a strong tendency toward depression on my mother’s side of the family.

Three months or so passed before I returned to work at the library (with diminished capabilities). I greeted the news of the sale of UK rights to my novel with a mixture of dread and pride. About nine months passed before the glumness faded, and by summer of 1999, I felt eager to be weaned off medications, which I believe did more harm than good.

As to the root cause of all of this, we continue to speculate. I didn’t smoke dope, so that was ruled out. At first I was content to believe that I was genetically disposed to mood disorder, and this is probably so. But with time, I have increasingly come to think that the antimalarial drug transformed a predisposition into a crisis. Perhaps this reflects a preference to externalise causes and allow oneself the comfort that such a terrible experience can be avoided, with better decisions. I feel myself again. But, of course, transformed too.

I fear the experience repeating itself in some new and unpredictable form, and this motivates me to monitor my mental health and cultivate it with exercise, diet and social interaction. If I find myself thinking negatively, I will pause to consider the true colour of my thoughts. Is it ordinary pessi-mism? Suspicion? Paranoia? Catastrophism? I find it useful to remember that thoughts can cross a boundary and become unhealthy.

My experience proved for me that a sound mind is something to cherish as much as a sound body, because, with surprise, I experienced the easy slide from routines of daily life to a state where you and your loved ones no longer recognise who you are. The change can come with alarming speed, so I am always grateful when I look at myself and find that this fragile gift remains intact.

Nervous System: The Story of a Novelist Who Lost His Mind, by Jan Lars Jensen, published by Icon Books at £12.99, is available from Times BooksFirst for £11.69, including p&p at 0870 1608080 or www.booksfirst.co.uk

What is psychosis and who can become psychotic?

Psychosis is most likely to occur in young adults. About three in 100 people will experience a psychotic episode in their lifetime, making psychosis more common than diabetes in young people. A quarter of sufferers never experience another episode.

The term psychosis describes experiences such as hearing or seeing things that others do not hear or see, and involves biological changes in brain structure or chemistry. One sign of psychosis is if a person lacks insight into their state of mind.

There are different ideas about why psychotic experiences may recur, but some people are thought to be more vulnerable.

Websites: www.mind.org.uk www.depressionalliance.org www.hearing-voices.org

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