Following the news of Kaylee Muthart, the 20-year-old woman who gouged out her own eyes while in a meth-induced psychotic state in February, PEOPLE looked into what happens to the brain when a person is under the influence of a dangerous stimulant such as meth and how it may lead them to commit a brutal act of self-harm.
Though gouging out one’s own eyes—known technically as self-enucleation—is a rare occurrence, there have been at least 50 documented cases in medical journals over the last half-century, according to the British Journal of Ophthalmology. Along with Kaylee Muthart, a recent high-profile instance of self-enucleation occurred in December of 2017, when a mentally ill inmate in Colorado gouged out his eyes using his own fingernails that hadn’t been cut in six weeks. The British Journal researchers said most victims of self-enucleation experienced hallucinations and have untreated mental illnesses such as schizophrenia.
In the case of Muthart, she experienced a psychotic episode brought on by her use of methamphetamine, which her mother says was likely combined with another unknown substance. Psychosis—a mental disorder in which the mind is so impaired that it loses contact with reality—is experienced in some 40 percent of meth users, says a study in the National Center for Biotechnology Information.
Once the meth enters the bloodstream—from either being swallowed, smoked, injected or snorted—it increases the brain’s levels of the neurotransmitter, dopamine. While dopamine is involved in a wealth of functions in the body, from motivation and movement, it is commonly known for its association with pleasure and reward.
Since meth releases high levels of dopamine that can last eight to 12 hours, it becomes highly addictive, and many users continually turn to the drug for the pleasurable “rush” it originally gave them.
Dr. Robin Gurwitch, who is not treating Kaylee, spoke to PEOPLE about the impact meth has on the brain.
“Meth releases dopamine at a level that blocks the brain receptors for so much longer than cocaine or nicotine, which also release dopamine,” says Dr. Gurwitch, a psychologist and professor at Duke University Medical Center and the Center for Child and Family Health and member of PEOPLE’s Health Squad. “The dopamine just builds up and users get this really positive feeling, which is why they continue to use it.”
A brain under the effect of a stimulant like meth can’t recycle the dopamine it releases. Instead of the chemical being pumped out of the brain’s synapses, a large amount of the neurotransmitter accumulates for hours on end. This causes neurons to fire off extraordinarily longer than they were ever meant to—which, in turn, creates this euphoric experience.
But how can a euphoric high take such a drastic turn as to lead someone to pull their own eyes out?
“There are multiple centers of the brain that get affected by meth,” says Gurwitch, who is not treating Kaylee. “It affects the judgment center of the brain, it heavily impacts the parts of our brains that make good decisions and understand the world around us.”
According to a 2014 study that imaged brains on meth, the drug was found to cause irregularities in the areas of the brain associated with risky decision making. In a state of psychosis, this inability to rationalize can have dangerous consequences.
RELATED: Mom of 20-Year-Old Daughter Who Gouged Out Her Own Eyes While on Drugs Speaks Out
The episode of delusion that Muthart experienced while on meth caused her to have a series of mental disturbances that affected her senses. Muthart’s mother told PEOPLE that while Kaylee hallucinated, her auditory capabilities were impacted, which caused her to hear things that weren’t there, such as the command to take her own eyes in order to get to heaven. Her visual senses were also distorted, as she saw “the world upside down and dark,” along with a collection of colored birds that surrounded her. In this state, someone can also experience disturbances to their other senses, leading them to smell, feel or taste things that don’t align with reality.
With her brain’s judgment center impaired, once Muthart hallucinated the command to gouge out her own eyes, she was unable to comprehend its repercussions, regardless of any pain she may have felt. (It is unclear whether meth can inhibit pain, though members of drug abuse forums have commented that it does.)
As Gurwitch mentions, a meth-induced psychosis can reoccur within a year or two after someone finishes using the drug. That’s why it is important former addicts continue to stay clean and get continued support. Muthart’s mother says she tried to convince her daughter to go into rehab just days before the incident and says she feels powerful regret that she was ultimately too late. Gurwitch says this is not uncommon for families of addicts.
“Trying to reason with someone who doesn’t believe they have a problem is really hard,” she says.
Though Muthart will live the rest of her life completely blind, Gurwitch says it’s important she knows that with her family’s support, she can still live a fulfilling life.
“With appropriate the treatment and support, she will be able to get her life back on track,” she adds. “The mother may need some emotional and mental support, too. As she helps her daughter, it’s important she helps herself as well.”
If you or someone you know is experiencing drug addiction, call the American Addiction Centers hotline at 1-877-927-6142