"Kill yourself! You're worthless! Why are you still here?"
The voices in Denise Baynham's head are ceaseless and demanding.
For three decades the 54-year-old has struggled with schizophrenia. The chronic mental illness twists how people think, feel and interact. It can spawn paranoia, delusions and auditory hallucinations. In extreme cases it can drive people to kill others or themselves. Sometimes the voices urge Baynham to wrench the wheel and drive off the road.
"Do it!" they urge. "Do it now!"
Resisting wears her out.
Baynham, who is on medication, is the assistant director of SIDE Inc., a peer-run organization that serves the mentally ill in Wyandotte County, Kan. Recently she was elected president of the Kansas Consumer Advisory Council for Adult Mental Health. Still, she must remind herself daily that she is a worthwhile person.
She'd like others to think that, too, although she knows not everyone will.
Schizophrenia has always been easier to fear than to understand. Recent publicity hasn't helped. The disease reportedly afflicted both accused Colorado movie theater gunman James Holmes and Arizona shooter Jared Lee Loughner.
That's no reason to stereotype, Baynham said.
"The first thing (the media) jumped at was 'could this have been someone with a mental illness who had schizophrenia?'" she said. "I just feel they think we all could go out and do something like this. That doesn't describe the kind of person I am."
Schizophrenia, however, affects everyone differently.
Angela Hardee, of Olathe, Kan., who asked to go by her maiden name for this article to protect her family, experienced schizophrenia's darker side with her son. Now 25 and in jail, he lost himself in a world of violence and paranoid delusions when he was just a teen.
It was a shocking turnaround from his happy childhood. Highly gifted and sensitive, he scored in the 99th percentile on national tests, wrote poetry for his grandparents and played complex pieces by Rachmaninov on the piano.
"He was a delightful kid," she said. "Very sweet and caring."
But by his 16th birthday everything changed. He screamed, broke things and flew into rages. Diagnosed with schizoaffective disorder, which includes elements of bipolar disorder, he began to hear voices telling him he was an Egyptian pharaoh or a Roman soldier.
"People were plotting to 'get him,' and he would get mad at me because I supposedly knew who they were and wasn't telling him," Hardee said. "And (he thought) there was someone who had invaded my body, and I wasn't really his mother."
Drugs and alcohol just made things worse.
Each day brought a new bizarre behavior. He'd put his shirt over his head and tell his mother not to look at him because her eyes were like daggers. He began to reek after he stopped taking showers, fearing that fluoride and chlorine in the tap water would scar his skin.
Hardee, a therapist with a master's degree in psychology, was powerless against his creeping psychosis.
A psychiatrist prescribed antipsychotic medication. The pills caused him to gain weight and lose his libido. Hardee began finding them under cushions, in potted plants, on top of the armoire. She called local mental health centers, but they were powerless to make him come in for help or compel him to take his medication.