I don’t know if it’s real… The meds don’t work… And it won’t stop smiling

When you suffer from schizoaffective disorder, you get used to visual hallucinations at some point. They don’t happen all the time, and when you stay on top of your medications and appointments, they become rather rare. But medications aren’t cures, breakthrough symptoms still occur, you might hear a voice that’s not there, you might see the occasional shadow person in your peripheral vision, what you might consider “normal anxiety” can escalate to paranoid suspicions with no precedent. Sometimes it’s just a stressful week and you just need to check in with your therapist, sometimes you need to tinker with your meds, but when you’ve been living with this your whole life you learn to be functional in spite of it.

Well, I thought this time was going to be just another normal period of breakthrough psychosis… But I don’t know what normal is anymore, if there is any hope… Or if I am safe

It began with the shadow people, as I said, I was already used to that. Sure, I can still get caught off guard and startled by them, but on the whole I wasn’t worried for myself, I was having a long week, extra hours at work, struggling to go to sleep, no big deal.

Then, one day while at work, I thought I heard my boss speaking to me, but when I turned around there was nobody there. I just laughed at myself, told myself to go to sleep at an early time that night.

And then, the smiles… I’ll admit, no matter how many times I’ve experienced this, they unsettle me every time, and the way they appear is hard to describe… It’s not like in movies where a hallucination occupies physical space, it’s more like reality warps to accommodate the existence of the smiling face, and then they disappear as quickly as they appear as if your own mind is gaslighting you

I called my psychiatrist and made an appointment immediately, dealt with several days of voices and smiling faces until I could get in, tell her everything that was going on, and have my doses increased.

Now the problem with dose increases is that they don’t take effect immediately, so I continued living with the hallucinations while feeling groggy from the new doses

Eventually, things felt like they were calming down, and then one morning I woke up… And there she was, standing at my bedside

Corpse like, head turned at an unnatural angle, eyes glaring right at me, with an uncanny smile, she did not move or say anything, just stood there staring unblinkingly

I immediately closed my eyes and shook my head, convincing myself that it wasn’t real, but when I opened my eyes again there she still stood at the foot of my bed

Eventually the shock washed over and I did my best to ignore her presence, though I was still shaking. I got up, trying not to look in her direction and did my best to get on with my day, but when I went to the bathroom, there she was standing there, same pose, same unnatural grin

I rushed to get dressed and ran out to my car and hurried to work, holding in my bladder to use the bathroom elsewhere, debating whether I was hallucinating or my house was haunted, then I looked into my rearview mirror… There she was, sitting in my back seat! I almost crashed the car at that moment but managed to collect myself just enough to focus and ignore the thing sitting behind me, convincing myself that I’ve gone off the rails, and made my way to work

A few cigarettes and 2 cups of coffee later I eventually collected myself, and the hallucination lost its shock value and I was able to carry on in spite of it. I figured I’ll just call my psychiatrist again, or if things get too bad, there’s always the hospital option, thank God for FMLA

The work day went uneventfully, and I got used to her presence, until finally, she started moving towards me. Now I was frozen in panic and didn’t know what to do, but I blacked out from the terror and next thing I knew I was on the floor cut up, and my coworkers immediately rushed in to help me… And wrenched out a bloody box cutter from my hand and looked at me in horror

I had nothing to say in defense of myself, what could I say to them? That some undead girl that only I could see cut me up and framed me? Or that I self harmed in a fit of psychosis? Both sound equally crazy!

The ambulance came and took me away, the boss just gave me a knowing look… This wasn’t my first rodeo at this job.

Now, when you arrive to the ER for mandatory psychiatric admission, you basically lose your rights, I couldn’t really speak for myself, all my stuff was taken away, and I just resigned myself to all of it. Some of the ER staff recognized me… Again, not my first rodeo

After a long day and night in the ER, and some benzos that probably did nothing, they finally moved me upstairs to the top floor. Recognized the psychiatrist from my last visit there, told him straight up what’s been happening in the last week, the hallucinations, the recent dose adjustment, and the sudden appearance of the corpse and how it felt like she came and attacked me.. I even admitted that I knew what it looked like and I probably hurt myself in a psychotic fit

For a few days during my mandatory hold, things seemed to be all right, my meds got adjusted again, did my daily sessions, did some art with the crappy art supplies they have

And then… She appeared again

This time it wasn’t a freeze… I screamed

Psych wards are a weird place, where you can feel safe to be your unfiltered crazy self

I was screaming, ducking behind the table, and throwing colored pencils at the corpse as it smiled at me, taunting me with her presence

Nurses immediately ran in, reassuring me that I was safe, and removing me from the rec room

After hyperventilating for a few minutes I eventually calmed down

I told them what I saw, the same thing I’ve been seeing for days, and it won’t go away

The figure continued to watch me from behind the windows of the rec room as the nurses carried me away

That night I struggled to sleep, even on a heavy dose of multiple antipsychotics, then suddenly I opened my eyes to see her again staring right down at me, she moved her hand up to my face revealing sharp claws, and then…. Sharp pain

There was a delay between the shock and pain, and my screaming response to alert the night shift nurses

The figure was now gone, but now my stomach was bleeding… And clutched in my hands? A colored pencil from the rec room

The nurse wrestled the pencil out from my hands and I was immediately taken down to the ER to get stitched up

I was recommended for ECT next, the psychiatrist told me my psychosis was treatment resistant, at this point I was ready for anything if it meant not seeing that thing again

After several rounds it felt like progress was finally being made, blocks of memory seemed lost, but that was a small price to pay to be rid of her

It was a long month in the hospital when I finally got to go home. The boss already took care of my FMLA for me and my coworkers were happy to see me better. Checked back in with my therapist and psychiatrist to let them know things were looking up

Then it happened one day at work, I thought I heard a coworker speak to me, but nobody was there… Then when I turned back to resume what I was doing, there she was again, head tilted, unnaturally wide smile, and her clawed fingers pointed forward….