He's a handsome man, tall and muscular with a shy smile. We'll call him Joe, because he seems like an Average Joe, the guy who may or may not catch your eye on the street.

But Joe isn't average.

Joe hears voices in his head, a trademark of schizophrenia. He flashes that shy smile when he tells how, a few years ago before his meds worked, the voices told him California was going to fall into the ocean and he would ride off on a killer whale.

The voices were powerful enough that one day Joe left his Montana home and drove west to be ready when Armageddon happened.

Joe worries about what people think of him, a symptom of an anxiety disorder. He lowers his head, and with guarded eyes explains how he relives conversations, agonizing over every word, body language and other nuance to the point where he's immobilized. He says it's like a gust of wind, blowing at him constantly.

Joe gets depressed. Not the typical blues, mind you, but a sadness that weighs heavy, keeping him from rising from bed some days. Along with the sadness comes physical pain.

Joe has wondered what it would be like to die, to stop the pain and end the sorrow. He's driven to the top of MacDonald Pass with gas cans, thinking of lighting them on fire, burning himself. He slept with a gun in his bed, a 30-30 rifle that went off when his father picked it up.

"The gun was cocked and ready to go," Joe's father recalls. "Then I was really mad. How stupid was it that I didn't even know how to deal with that at the time?"

Joe said he didn't necessarily feel suicidal, even though it's the leading cause of early mortality in people with schizophrenia.

"I wondered what it would be like if I was dead, (that) was the way I felt," Joe recalls, sipping a glass of water, his mouth dry from his medication. "... All the pain would go away, you know?"

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Joe is one of almost 60 million Americans -- nearly one in four adults -- who experiences a mental health disorder in any given year. One in 17 American adults lives with a serious mental illness like schizophrenia, depression or a bipolar disorder. One in 10 children has a serious mental or emotional disorder.

Untreated mental illness is often called America's No. 1 public health crisis.

In 2006 in Montana alone, more than 121,000 adults were estimated to have a mental health condition causing them to lose at least a week of work. Of those 121,000 people, an estimated 38,500 met the federal criteria for serious mental illness. About 22,000 of those people are low income, unable to hold down a job because of their illness.

Yet despite his schizophrenia, Joe is lucky. He has a family that wouldn't let him go, who picked him up when he fell through the cracks in Montana's mental health system. They spent hundreds of thousands of dollars for in-patient and out-patient treatment, finally helping Joe get the proper medications to wrest him out of the dark abyss of his own mind.

Today, Joe lives on his own, holds down a part-time job, enjoys running and hanging out with friends.

But it wasn't always that way. And just because Joe is functioning well in society today, there's no guarantee he will be tomorrow. It's like asthma or diabetes, a disease that isn't always outwardly evident but is always present.

"He continues to struggle with his illness every day," Joe's dad confides. "The voices come and go. He gets panic attacks about once a week. But he's getting better."

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Joe grew up in Helena. He was attending high school in the mid 1980s, but suddenly one summer he left the family home only twice. He was scared about school ending, about his future. He decided he couldn't go to classes. He was 16 years old.

"Depression hit me real hard. It's like cement being poured on you and you just can't move. You just feel like you're going down and down and down a stairway, ..." Joe recalls. "My head was just swimming with anxiety and depression and I couldn't for the life of me concentrate on school."

His parents brought in a tutor, but Joe couldn't concentrate on the books. He wouldn't answer the door when the tutor came by. His parents suspected he was abusing drugs or alcohol. They sought family counseling, and therapists put the blame for Joe's symptoms on his family. No one suspected mental illness.

"They put us in a room and told us to bitch about how they screwed me up, which wasn't true," Joe said.

He tried to finish school in Missoula, but the former honor student dropped out again.

His mental illness onset resonates with professionals, who say that for some unknown reason -- maybe a genetic predisposition, triggered by environmental factors or a maturing brain, or maybe altogether different -- these disorders often manifest themselves during the teenage years. All too often, it's confused with teenage rebellion or drug and alcohol abuse.

His parents decided to look for help outside of Montana, and found a clinic in Kansas, where Joe was hospitalized for two months and treated for depression -- at a cost of $35,000 per month.

"It was scary, very scary," Joe said. "It was a real nice place but there were some real creepy people there. I don't want to get into it but they were off base by quite a bit."

The doctors recommended Joe be transferred to a group home, but the family couldn't afford the $200,000 annual price tag.

So Joe came home.

On Presidents Day in 1990, Joe had a psychotic break. He had started hearing voices when he turned 22. The voices convinced him to drive to California.

"It's almost like listening to a radio in your ears. There's like hundreds of them," Joe said. "A few say that I'm going to die of an aneurism, or going to get cancer, or needed to go to California.

"... The voices would talk so I would be sitting here talking to myself, mostly whispering, carrying on a conversation with the voices."

After a few weeks, Joe called his parents, telling them he was on Wilshire Boulevard and needed some money. He was going to save the world, but had parked his car and couldn't find it. He was living on the street.

Joe found his way to an aunt's house in California. His father was convinced Joe was mentally ill, but Joe's mother wasn't so sure until she arrived at the aunt's house and her son was talking to invisible people. He wouldn't bathe.

He also refused to return home. Legally, Joe wasn't a danger to himself or others, so his parents couldn't force care on him. His mother tricked Joe n they don't want to elaborate, but add that it's an inside family joke n and brought him home.

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Joe's family thought he needed treatment. Joe disagreed. So the family got a court order, committing Joe to St. Peter's Hospital for a month.

He wouldn't participate in therapy or ingest his drugs until a judge gave Joe a choice -- take the medications or take a trip to Warm Springs for a stay at the state psychiatric hospital.

"That probably was the best thing that ever happened," Joe said. "I was pissed. I was really mad, but I didn't want to go to Warm Springs."

He continued seeing therapists, who tried different medications. Halodol was like shuffling around. Prolixin stopped the voices temporarily, but not when Joe was around others.

He went to the Center for Mental Health in Helena, where Joe says most consumers just sat around and smoked cigarettes. He was estranged from his friends and struggling with his family.

Eventually, Joe tried Clozaril, an antipsychotic used to treat people with schizophrenia who don't respond to other medications. It worked.

"Within two weeks he was back to us," Joe's father said. "But it destroys white blood cells, so he has to take biweekly blood tests ... and he throws up dinner probably five nights a week. We've tried other meds, but the voices came back."

Clozaril isn't a cure, but it helped Joe return to the real world. He attended a psychiatric rehabilitation university in Boston, learning life lessons like balancing a checkbook, grocery shopping and computer skills.

If he became anxious at 2 a.m., he could call a psychiatrist at the school, who said he'll be available for the rest of Joe's life and has visited him in Montana. He had a personal trainer at a gym. A nutritionist helped plan meals. A counselor taught stress reduction techniques.

"They taught him how to have a life in spite of his illness," Joe's dad noted.

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When Joe returned to Montana, he found a therapist who's helping continue treatments. He found a job with limited hours, since his illness prevents him from working full time. He has a home of his own, with a little help from his family.

In the 25 years Joe has worked through his mental illness, he's watched as various disorders have been drawn out of the shadows where he dwelled for so long, into something people are willing to talk about.

Newsmen Mike Wallace and Larry King publicly acknowledged their battles with depression. Actors Carrie Fisher and Patty Duke are upfront about their bouts with bipolar disorder. Nobel Prize winner John Nash, Pink Floyd band founder Syd Barrett and author Jack Kerouac all acknowledged schizophrenia diagnoses.

But Joe isn't willing to become the face of mental illness in Montana just yet, which is why the Independent Record has agreed to keep his identity secret. Despite the willingness of others to come forward, Joe feels there's still a stigma attached to mental illness in Montana.

And even though he feels good and he feels strong, Joe still struggles with his mental illness, trying to tame the beast within.

"If I had to say 100 percent was what I was before, I'd say I'm maybe 60 percent now," Joe said.

And does he strive for 100 percent?

"No, I'm good for right now."

To view the complete series on mental health care services in Montana, click here.