He knows it’s all in his head.

Everyday is a battle with paranoid schizophrenia. things are going well for Sebring now. For three years, he has held down a full time job and paid for his own apartment. It took him more than 30 years struggling with drug abuse and homelessness, though, to get the upper hand on his mental illness.

Mental illness ranks third after substance abuse and lack of affordable housing on the list of the most commonly cited causes of homelessness. between 20 and 25 percent of the homeless population in the United States suffer from some form of severe mental illness, according to the Substance Abuse and Mental Health Services Administration. The percentage nearly doubles if lesser illnesses like clinical depression and anxiety disorders are taken into account.

When it comes to beating homelessness, it’s these people who often struggle most, said Neil Donovan, executive director of the National Coalition for the Homeless. many turn to illegal drugs as a means to self medicate.

“Pulling out of homelessness is hard,” Donovan said. “Mental illness makes it exponentially harder.”

But there is hope. Sebring is proof of that.

Sebring, a short, stout man who keeps his cinnamon-colored facial hair trimmed in a neat goatee, smoked his first marijuana joint in the fourth grade.

His grandmother, who raised him, was a chain smoker. one summer evening, he snuck a cigarette from her stash and took it behind the chicken coop. he lit. he inhaled. And he gagged. The smoke burned his lungs. It tasted terrible. That might have been the end of it, but, just then, his uncle came lumbering through the bushes. Watching Sebring hacking and hacking, the uncle shook his head.

“Don’t smoke cigarettes,” he said. “I’ve got something better.”

The following decades were a drug-induced blur. Sebring became a drug dealer. he got kicked out of one school and failed most of his classes in the next. he isn’t sure when he started experiencing symptoms of schizophrenia. It was hard to tell the drug hallucinations from the schizophrenic ones. he couldn’t sleep because the voices in his head were too loud. he self medicated by doing more drugs.

“The voices were relentless,” he said.

“Leave the state,” the voices told him. “You’re an alien.” “The FBI is tracking you.”

Last Updated: August 12. 2010 1:00AM Dr. Paul Donohue: Your Health

Dear Dr. Donohue: Do your readers a favor by telling them about Cushing’s syndrome. it took six years before I was diagnosed. the delay cost me my job and my fiance. I gained weight and had stretch marks all over. Doctors told me to lose weight by dieting and exercise. I did both, but continued to gain weight. Then my blood pressure rose. Finally, a doctor, to whom I owe my life, came up with the correct diagnosis. I had an operation, and my life has changed for the better.

P.A.

Dear P.A.: Cushing’s syndrome is an overproduction of cortisone. our adrenal glands, sitting above the kidneys, turn out this hormone, which is essential to life.

At first, an overproduction of cortisone produces signs and symptoms that are quite subtle and go unrecognized. As time goes by, weight is gained, the face becomes round and red, the arms and legs remain thin, the chest and abdomen expand. the skin thins and is easily injured. Purple stretch marks appear. Menstrual irregularities occur. Women sprout facial hair. Muscles weaken, as do bones (osteoporosis). Blood sugar rises, and so does blood pressure. all of this comes from having too much cortisone.

The trouble can lie in either of two places, the pituitary gland on the underside of the brain, or the adrenal glands (above the kidneys) that make the hormone. the pituitary gland produces a hormone that stimulates adrenal-gland production of cortisone. Tumors of the adrenal gland, independent of the pituitary gland, can rev up their production of cortisone on their own.

It’s treated by turning off cortisone production. Surgery is the answer to both causes of Cushing’s. With the pituitary gland, the approach can be through the nose or roof of the mouth to reach the pituitary gland and destroy the tumor. When the adrenal gland is the cause, surgery is more involved.

Dear Dr. Donohue: my artificial sweetener has a warning saying it contains phenylalanine. why? is it a dangerous material?

K.S.

Dear K.S.: Phenylalanine is an amino acid, one of the bricks from which the body builds proteins. it is not a dangerous material. However, a few individuals are born without the ability to metabolize this amino acid. Discovery soon after birth is important so that phenylalanine can be eliminated or severely limited in these babies’ diets.

Write to Dr. Donohue at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from rbmamall.com.