Sam Miltich thought about ending his life not because he was sad, he says, but to save the world.
"I held this belief that I was the antichrist," he recalls. "I thought that I was responsible for the I-35 bridge collapse. ... I thought every move I make is connected to some horrific events."
That was 2008, and Miltich, a 22-year-old jazz guitarist from Grand Rapids who was living and working in the Twin Cities, was experiencing a major psychotic breakdown.
Now married, the father of two school-aged sons and living back in Grand Rapids, Miltich continues to work as a jazz musician while advocating for mental health awareness. Both will be represented on May 14 when Miltich brings his "The Improvised Life" show to Denfeld High School.
To do all of that, Miltich has had to learn how to manage his illness, which was diagnosed as schizophrenia.
The term might be thought by some to mean split personality, but that's a wrong understanding of the illness, Miltich said.
"That's been part of pop culture, the idea of a split personality," he said. "When you're talking about schizophrenia, it's more like ... a split from reality."
Interviewed separately, an Essentia Health psychiatrist confirmed what Miltich had said.
"People with schizophrenia don't have multiple personalities," said Dr. David Baldes, medical director of adult in-patient psychiatry at Miller-Dwan.
But they are hit by a nasty combination of "positive" and "negative" symptoms, he said. The "positive" can include hearing voices, hallucinations, delusional beliefs that seem very real, disorganized thinking and behavior. "Negative" include decreased social engagement, inactivity and "general disengagement from life."
It's not a curable disease, Baldes said, but it is manageable - and much more so now than it was 30 years ago.
"If symptoms of schizophrenia are detected early and treated early, there's a very good chance to control the illness and living a productive life," he said.
About 1 percent of the population has schizophrenia, Baldes said. It's more prevalent among men than women, and most typically diagnosed when the individual is in his early or mid-20s.
Family jam sessions
Looking back, Miltich said signs of the disease appeared in his youth.
"I had a fairly challenging adolescence," he said. "We had some family tragedy. I lost a sibling, and we had a house fire."
Meanwhile, his musical talents were developing rapidly. It came naturally, because Miltich was born to a family of musicians. His dad plays string bass, his grandmother was a cellist.
"And then all my aunts and uncles, they all played music," he said. "So there's a lot of family gatherings, and it was always a jam session in the house. ... My way of becoming part of the family circle was by picking up the guitar."
Michelle, then early in her career, was wary of singing with a literal "house band" of uncertain talents, she said last week. But her fears were allayed.
"It was so much fun," Michelle said. "(Sam) had studied the CD that his dad had bought. He knew all of the music."
Over the years, Michelle frequently has collaborated with Miltich. She enjoys working with him, she said, because they share a love of rehearsing, of getting the details right. "We demand perfection of ourselves."
Originally inspired by "gypsy jazz" guitarist "Django" Reinhardt, Miltich would practice eight to nine hours a day. By age 18, he had performed at Lincoln Center in New York and with one of Europe's hottest jazz bands in Amsterdam. He was profiled on National Public Radio's "Morning Edition" - a teenager from a wooded area near Grand Rapids excelling in a very urban form of music.
A 'deep disconnect'
He followed his girlfriend - now his wife - Katie Marshall to the Twin Cities, where the musical opportunities were greater. He was taking classes at a community college, trying to work and "starting to lose it," he said. "By the time June (2008) came, I just really had a pretty deep disconnect with reality."
He thought the police were after him and would put him in solitary confinement. He thought people could read his mind. He could hear voices.
"The primary experience of psychosis is fear," Miltich said. "It's a terrifying and disorienting experience. And you kind of lose your sense of self. You don't really know who you are anymore."
Once diagnosed, Miltich embarked on managing his disease. It took two years to reach a point of stability, he said. He remains stable by faithfully taking his medications, being vigilant about nutrition and exercising, he said.
That has become all the more important just this year. On Feb. 16, he woke up to discover that he was deaf in his left ear. It turned out that a virus had attacked his inner ear. He has recovered some hearing in his ear, Miltich said, but has had to make technical modifications to compensate when he performs. And the treatment included Prednisone, a drug known for significant side effects. Some of the schizophrenia symptoms returned, including auditory hallucinations.
"And I knew I just had to sort of like grit my teeth and get through it," he said. "And I had to kind of keep reminding myself, like, 'Well, the reason you're sobbing is because of Prednisone mood swings. The reason your heart is racing is because of the Prednisone.' "
Although the inner ear only has partially healed, the side effects of treatment largely have subsided, Miltich said. Meanwhile, he continues with "The Improvised Life: Exploring Intersections of Mental Health and Creativity With Jazz," a program in Greater Minnesota venues funded by a grant from the Minnesota State Arts Board.
Talking about it
Northland Healthy Minds invited Miltich for the gig at Denfeld. It's separate from the grant funding, but will be the same program, Miltich said. He tells his story and talks about mental health issues. That's interspersed with the band performing some of his compositions and some by jazz great Thelonious Monk, who like Miltich was a husband, a father and a musician. It is believed by many that he was bipolar, living with a mental illness that causes extreme mood swings.
One of the band members is Chris Bates, a bassist who has known Miltich for about a decade, he said.
Miltich didn't talk about his mental illness with fellow musicians until a few years ago, Bates said. But it made no difference. "I never experienced anything from him that led me to believe that something was different or wrong."
He calls Miltich one of the most genuine people he has ever met.
"Since Sam started talking about this a few years ago, he's just allowed it to become part of his life, and I think it's allowed him to address some of his symptoms in a different way," Bates said. "He's not afraid to talk about it and advocate for others."
Michelle also used the word "genuine," as well as the word "kind," to describe Miltich. They've become so close that Miltich stays with her and her husband when he's in the Cities for a gig, she said.
She sometimes can tell that Miltich is "on edge," Michelle said. But she also said, "Whenever I'm working with him, I feel absolutely comfortable. We do the preparation. We're ready."
Although "The Improvised Life" is for everyone, Miltich said he invariably connects directly with someone in the audience.
"It's always really emotional when we do this show," he said. "Because there's always someone who's in the first year or two of someone (in their family) being diagnosed, and it feels like their family member has slipped away. It's incredibly painful and hard.
"My message is: No, there's hope. Don't give up."
Mental health awareness events
"The Improvised Life" is one of several events Northland Healthy Minds is presenting in May, which has been designated as Mental Health Awareness Month.
• Opening of the art exhibit "What Mental Illness Feels Like," 5 to 7 p.m. Thursday, Zeitgeist, 222 E. Superior St. The exhibit will be displayed through May 15.
• Free Fridays during May (except May 24) at the Duluth Family YMCA, 302 W First St. Learn more by calling (218) 722-4745.
• Documentary screening of "Call Me Mental," followed by a discussion, 7 to 9 p.m. May 7, Zeitgeist.
• "Wear Green Day" is May 9. People are invited to wear green to show support and reduce the stigma of mental illness. Snap a picture and send it to email@example.com. Enger Tower will be lit green in the evening.
• Free community dinner and mental health resource fair and program featuring musician Sam Miltich, May 14, Denfeld High School, 401 N. 44th Ave. W. The resource fair and dinner will begin at 5:30 p.m., and Miltich will take the stage at 6:30. Free child care is available; email firstname.lastname@example.org.