http://www.guardian.co.uk/weekend/story/0,,2003775,00.html

The man who smoked dope to stay ill

Alexander Linklater
Saturday February 3, 2007
The Guardian

After lights-out, at around 11pm, four 14-year-old boys sat in Dan's room, gazing nervously at the little brown lump in his hand. Dan was their ringleader, and he was good at rolling cigarettes, so he stuck together the Rizla papers. It took a bit of experimentation, but then he figured out how to heat the hash to make it crumble. He put it all in, swivelled the papers, and licked off his first joint.

"Ya, mon, sweeeet," Dan rejoiced in his best 1980s Rastafarian accent. The other three gawped as he smoked. They'd all been performing together in a school play, and this was meant to be their rebellious celebration. But, when it came to the moment, the other three boys shied away. Not because they were afraid of being expelled from their elite boarding school; more because of all those spooky stories about ending up in some druggy hell. Dan giggled as they filed out. What a bunch of poofs! Dreamily, he lay back on his bed and let thoughts of his own brilliance dance around the Bob Marley poster on his wall.

Dan had been playing Prospero in a triumphant version of The Tempest - so triumphant that a visiting teacher from a London acting college had said it was the best Shakespearean performance by a child she'd seen. Amazing to watch a 14-year-old transmogrify so completely into the despairing old man of magic. Each night for a week, Dan had wept real tears as he spoke Prospero's epilogue of submission to the audience: "Now my charms are all o'erthrown. And what strength I have's mine own, which is most faint..."

These days, in his late 30s, Dan will still cry if he tries to recite those lines. They represent the last time he did not have to struggle for his sanity. A year later, he was in hospital. Those other three boys all went on to careers in TV and film, made money, had children. Dan's career had been a two-decade journey through the psychiatric system, cursed by a disorder that combined the wild moods of manic depression with the delusions of schizophrenia.

A Freudian psychoanalyst once tried to explain to Dan what had precipitated the onset of his psychotic episodes. His childhood had evidently been happy, so the analyst had talked about the effects of imaginatively imbibing the haunted universe of The Tempest at a vulnerable point in adolescence. He had described Dan's manias and hallucinations as "psychic retreats". When Prospero gives up his magic, he is faced with the intolerable reality of being merely human. Dan would rather flee to a psychotic hell than remain bound to such a reality. "Now I want Spirits to enforce, art to enchant," as Prospero says. "And my ending is despair..."

Current psychiatry scoffs at such cranky interpretations. Scientific evidence suggests that schizophrenia and bipolar disorder spring largely from inherited pre-dispositions; indeed, Dan could cite a manic-depressive grandmother and a schizophrenic great uncle as genetic precedents for his own condition. Genes are just part of the equation, however. Thereafter, the question turns to the triggers. What transforms a predisposition into a disorder?

One trigger can be dope. A pivotal psychiatric study, conducted over 20 years in New Zealand, recently suggested that one in four teenagers is dangerously susceptible to cannabis use. Those in the study who tried it at the age of 15 were four and a half times more likely to develop schizophrenia by the age of 26 than those who did not. The implication of a specific interaction between cannabis and a variety of the COMT gene nevertheless remains controversial. Is this a deep cause, or a mere association?

What remains clear, however, is that cannabis - especially new and powerful types of hydroponically produced "skunk" - are acutely risky for those who already have psychiatric illnesses. Dan has never really been into drugs, but his psychotic episodes have often developed after a casual smoke. On one occasion, his grim Scottish psychiatrist was so enraged by the stupidity of taking the risk that he gave Dan an ultimatum. Either quit cannabis for ever, or find another psychiatrist. "You know what I just said to an addict with schizophrenia?" Professor Boyle asked rhetorically. " 'Stick to the heroin if you must, laddie, but stay off the weed!' "

Dan felt cornered. He groped for an explanation. For almost a year before the last episode he had been OK. Life had been shit, of course, but at least he hadn't been ill. What he blurted out next felt peculiar, as if he'd actually known all along what he'd been doing. He wouldn't call it a psychic retreat as such, but after 20 years of madness, psychotic experience was more familiar to him than normality. "I smoke dope because I can't cope with staying well," he said.

· Names and details have been changed.