Two Faced

I knew as a teenager that I had bipolar disorder. Begging my parents to take me to see someone, my father insisted I was just a moody teenager and I would grow out of it. Instead of self-medicating like a lot of people do, I wrote on and on for hours. I continued to have imaginary friends that I would talk to in my head even though I had a pretty good group of friends at school. Always putting on the brave face, everyone at school thought I was fairly happy. I was into the goth scene, I always preferred the slightly classier Victorian influenced gothic style, but inside I was tearing apart with mania and depression.

The events of my late teens and early twenties were filled with situations that likely worsened my then undiagnosed disorder. My parents had a messy divorce, like many families; though my parents’ divorce was very unusual and could have been a made for tv movie. I will not go into specifics here, but it was not the usual messy divorce. This went on for years. After I graduated high school, came my self-medication. I drank a lot and I liked pills. Inside my head the imaginary friends were still there to comfort me but that sneaky voice of depression was ever present to beat me down.

I attended college for a few semesters, doing well sometimes and basically giving up at the end of some semesters. Finally my depression deepened to the point where I begged my mother and grandmother to do something for me. I was sent to a doctor who I unloaded on with all my scary stories of depression, thoughts of suicide, reckless behavior, promiscuity, but I left out the imaginary friends.

He told me he could not handle me and sent me to the one psychiatrist in our area.

Adventures in Psychiatry

Our town is small, consisting basically of three of four smaller towns that make up a pretty rural area. The psychiatrist immediately diagnosed me with bipolar disorder. I was given several prescriptions that I cannot even recall now and saw her on a monthly basis. Her office was overloaded, and the medication was not making me feel any better. My boyfriend, who later became my husband, put up with many days of crying, over-reacting, and semi-manic behavior. I gave up on her and dismissed her diagnosis.

My thoughts were that maybe all the alcohol and drugs were giving me the symptoms of someone with bipolar disorder. My family doctor put me on an antidepressant and everything was great because I later realized it sent me in to super manic mode. There were a variety of antidepressants and then anti-anxiety meds. Then I became pregnant.

I took Lexapro the entirety of my pregnancy. I still suffered terrible post-partum depression but told no one. Keeping to myself I rarely maintained self-care. My daughter stayed in my lap or laid next to me while I played video games. My imaginary friends were there to try to help me.

When I say, “imaginary friends,” it is difficult to describe. I do not remember how I envisioned them as a child but in my adulthood, it is a revolving door of fictional characters that I carry on conversations with in my head.

My late twenties were a blur of maintaining employment but at different jobs. Impulsivity was my enemy, causing me to walk out of many jobs simply because they pissed me off. Friends and my husband tended to say I didn’t seem the same, my husband accused me of keeping my thoughts to myself too much, which resulted in him reading my personal writings to get an idea of what was going on in my head. That did not go well.

I tried to raise my daughter the best I could. I had help in the form of my mother-in-law, my mom, and my grandmother, and of course my husband. But I always felt like a failure of a mother, imagining what my daughter would remember when she grew up; looking back on her crazy mother than could barely keep in together in private but tried to put on a brave happy face in public.

Ten years later I am in my thirties. I cannot maintain anymore. Even though I am employed the ever-present thought of suicide scratches at me. My “imaginary friends” are still a coping mechanism but often tear through my marriage because my husband does not understand. I started seeing a psychiatrist, but he was only treating me for depression and anxiety.

Last year I started seeing a therapist. She believed me to have bipolar disorder as well and sent me to a facility that had doctors and nurse practitioners that helped people with lower incomes. The NP diagnosed me with bipolar disorder type II and asked me a plethora of questions. This time I was brutally honest. I told her about the voices and the imaginary friends, anything I could think of that would help. She suggested that I might have bipolar disorder type II with psychotic features, at times, but as long as I did not feel like it was interrupting my life simply take my meds and use my coping mechanisms but to continue seeing the therapist.

The therapist was a disaster. Basically, every visit consisted of her telling me to leave my entire life behind, take my daughter, and start somewhere fresh. This was not fiscally possible and seemed like terrible advice. The visits then devolved into me having a personality disorder, I suppose because I would not take her advice. I stopped seeing her. I stopped seeing the NP she was associated with and went back to my psychiatrist I hadn’t seen in three months with this new information.

He kept me on the mood stabilizer I was on, gave me an additional small dose of Trintellix, and kept me on my anxiety meds. For the most part life is much better now, meds have to be adjusted now and then but I no longer want to kill myself on a daily basis. That is not to say I don't have breakthrough episodes of depression and mania, I find myself in too much credit card debt. The imaginary friends are not as vocal as they once were and I can pretend to be somewhat “normal” much easier now.

But a question still haunts me. Even though these “imaginary friends” that are voices in my head are never malicious, the only voice that ever is or was is my own internal voice that would tell me to kill myself, could I be schizophrenic or schizoaffective? No one has ever addressed this issue, for the exception of my psychiatrist temporarily treating me for intrusive thoughts but the medication made me a zombie and was stopped. As far as I know my psychiatrist only added intrusive thoughts to my medical records. Yet I am left with the fear, or maybe some morbid hope, that one day reality will breakdown for me and my imaginary friends can relieve what continues to bug me, not suicidal depression, but an overwhelming feeling of unhappiness that is bandaged by the thought that I might one day be able to make a career out of this disease.