This was when it really hit me, it was happening again. Walking to class, I enjoyed the feel of the crisp air around me. The smells of late autumn and the colors of the leaves decorating the earth were calming for me. A woman walked toward building I was headed for, coming from the other direction. I recognized her but couldn’t place from where. I smiled and, since I reached the door first, held open door for her, but when I looked up expecting her to be right there, I stared out into empty space. I was alone.

I struggled at first to understand what had happened, wondering if I had perhaps simply missed her and she had walked away somewhere outside of my sight. But I knew I had seen her right there, there was no where she could have disappeared to. I began to wonder if those times I’d seen her in the past were hallucinations too. I began to wonder what else wasn’t real. I took a deep breath, held it for a minute in an attempt to calm myself, and then headed inside, not wanting to be late to my class.

I’ve noticed a pattern over the years. Every six months or so, just as it is turning summer and just as it is turning winter, something happens with my mental state. Sometimes depression, sometimes hypomania, usually something psychotic too. This time it began with moodiness; My highs got higher, my lows got lower. I could switch from elated to depressed in a second for no reason at all. But then slowly, my lows became longer, and my highs became less frequent, until I was experiencing mostly deep lows the majority of the time, with the occasional intense high.
I went to my psychiatrist for help, and she prescribed me a new medication, a mood stabilizer that was supposed to really help bipolar depression. I went on it, but didn’t feel much different. It was around this point however that I started to experience my other symptoms, psychotic symptoms.

I first really noticed that I had psychotic symptoms in February 2014. I was in a psychiatric hospital for suicidal ideation, and I my friend was telling me how she was concerned because she saw shadows out of the corner of her eye. I had never really thought about it but I did too, I just didn’t know that was unusual. Not only did I see shadows but occasionally I would hear whispers, sometimes calling my name, sometimes saying indistinguishable words.

Following my six month pattern, this went on for half a year, until it started to change. I started seeing people that weren’t real, just standing or sitting around. I knew they weren’t real because,

A) They were mostly in mine or other people’s houses so since I didn’t know them I knew they didn’t belong
B) They appeared and disappeared very suddenly
C) They looked like they came from the depths of hell. Ghastly faces, the embodiment of pure evil and terror

I called them demons, and needless to say I was terrified by them. I would wake up and they would be standing at the foot of my bed staring at me. I would walk into a room and they would just be sitting there. One morning at my ex-girlfriend’s house, I was in bed and I looked up to see at the foot of the bed a girl with black hair and paper white skin staring down at me with this look of pure evil in her eyes. I jumped, but my ex didn’t see her. This girl disappeared pretty quickly, as suddenly as she had appeared, but she left me with a feeling of terror and the memory of it permanently burned into my mind. At first these hallucinations happened a lot, but they became less and less frequent after I went up on medication.

Six months later, like clockwork, it changed again. This time my whole surroundings would be distorted. Walls and floors would move and ripple. It was very disorienting. But I again changed medication and that mostly subsided.

Half a year later yet again it changed. Now I was seeing people, not demons, but very real tangible people. Cars too. Just being normal, walking around, smiling at me, and minding their own business. I would only see them where it made sense to see them, like on my college campus or on the road. The only way I knew they weren’t real was because sometimes when I would look away and immediately look back, they would disappear.  They weren’t scary, they just were. But I began to question my reality, what was real, what wasn’t. I had trouble telling, I could never tell things were hallucinations until things would disappear impossibly. But I raised my medication and they seemed to go away.

Several weeks ago I started seeing both the demons and the normal people again, plus added paranoia. I’ve always been a little paranoid people are trying to poison my food, but it’s never really bothered me too much. I can often just decide that’s a ridiculous notion, or if I must I can just skip eating or drinking that one thing. However this time I became increasingly concerned people were trying to poison my food, and I even started thinking that the government was putting microphones in my house. I had a lot of trouble reality testing these notions. It rose to such a problem that when I got a refill on medication I became convinced my pills had been tampered with and had a lot of trouble taking them for days.

I went back to my psychiatrist. Driving over to her office I spent the time thinking about how I was going to tell her what was going on. I didn’t want to tell her about my paranoia, she wouldn’t believe me. Nor about the hallucinations. I wasn’t even sure I wanted them to go away. They were a big part of me, they kept me safe and they were mine. My world. I didn’t want to give them up, any of it. But I knew I had to.

As I entered the parking lot of her office building, still mulling over how to tell her, I saw a man standing by one of the parked cars. Since there were no empty spots I decided to wait for this person because they were likely pulling out. Except nothing happened. I pulled up closer and discovered no one was there. There was no where he could have possibly gone, I was watching the whole time. It took me a few minutes but I finally admitted to myself that he probably never existed, and then shakily went to find another parking spot.

Seeing things is so nerve racking, simply because, you can’t tell what else isn’t real. There’s no way to know if you’re reacting to something legitimate or a figment of your mind. Everything and everyone could be fake, it could all be in your head, and you wouldn’t know. It’s terrifying, and it’s dangerous.

Say you’re driving and a car stops short, or a pedestrian runs into the road. Say you stop short to avoid hitting them, what if there was no one there? And now you just risked getting hit yourself by cars in back of you. But what if you don’t stop, you just assume they aren’t real and keep going. What if you kill someone? There’s no good answer. Obviously you should act as if they are real, air on the side of caution, but should you really be driving at all then? I had to wrestle with this question.

When I entered my psychiatrist’s office I relayed to her as best as I could what was going on, despite internal voices shouting at me not to. She lowered my dosage of the new mood stabilizer to see if that was the cause of all my problems. This made everything much worse.

My mood began oscillating between elated, agitated, and depressed, very quickly. I began having suicidal thoughts, I couldn’t be trusted alone. All of this, and my psychotic symptoms didn’t even go away. So after a few awful days she put my back up on the drug, and raised my antipsychotic. It took a couple of weeks but I began to feel normal again. I began trusting my reality again, that my thoughts were legitimate, that what I saw was real.

A couple of weeks later, it was getting dark, the air was cool. We were on the road, my family was headed over to a family friends for dinner, when it started up again. It started subtly. I noticed that morning my depression seemed to be rearing it’s head but I didn’t think much of it, that’s very normal for me. On the way over I kept seeing shadows, and I thought I saw someone run across the street as we were driving, but I ignored these, they didn’t matter much. I figured I was just overreacting. I managed to make it through dinner without anything happening, but I couldn’t shake the feeling that something was off.

The next day was Christmas. I’m Jewish so I don’t celebrate it, but my grandmother does and so I drove over to her house for a Christmas lunch. I was feeling pretty depressed but I decided it was nothing I couldn’t handle so I ignored it, as per usual. It went fine while I was at her house, on the way home however, something happened. I had music playing and I was enjoying the drive, talking with my little sister, when suddenly a very loud siren started up. I looked all around but couldn’t find the source. I was on the highway so it was unlikely it was coming from a side street, I knew it wasn’t in back of me and I knew it wasn’t on the other side of the highway. It didn’t exist. I wanted to hold my hands over my ears, it hurt to hear. It made driving harder. But I gritted my teeth and turned up my music and eventually it went away. It didn’t last too long but it really got to me. I got us both home safe, but I wasn’t sure what to do. I called my psychiatrist, who raised my antipsychotic. I just had to hope it would work.

4 days later, hoping everything would be ok, I went out again with my family. I didn’t drive. We went ice skating, which sounded like a fun easy thing to do, even when you feel like your world is slowly falling apart. We got there and I got on the ice. It took me a few minutes but I quickly got accustomed to it and started around the rink confidently. I started to really enjoy myself for the first time in awhile, I felt calm and free. I went around a couple of times before I started hearing a name being called. I looked around but couldn’t find the source. It kept happening, different voices, same name. My name. I determined it was unlikely there were multiple people calling my name, and so the voices were probably in my head. I didn’t want to let it get to me but it was unsettling. I decided to keep skating though. A couple more laps and suddenly my vision started changing. Everything got brighter, richer, kind of like a dreamy state. It would go in between that and normal randomly and I decided I had to get off.

I called my psychiatrist, who was genuinely concerned about the voices, and raised my dosage by twice the usual incrementation. It’s only been a few days since then, everything has been ok so far. But I worry what will happen next. I am still depressed, more so than before even, so I know it’s possible something will happen again. I worry if I will be able to hold it together. And yet, even as I worry about this, I have a strong urge to stop taking my medication all together. Even though I hate these symptoms so much, even as I feel them tearing apart my reality, it is still a part of me, and I don’t know who I am without it. I don’t know how to confront reality. It’s scary when you can’t tell if anything is real, but it’s terrifying when you know it is all real and you have to deal with it.