Content Warnings: mental health, disability, bipolar disorder, schizoaffective / psychotic symptoms, suicidality, hearing voices, dissociative disorders, electroconvulsive therapy, partial psychiatric intake programs, COVID, PTSD / CPTSD, loss of resources, loss of function, grief
I try to consider the ways my life could have gone differently sometimes, but there is one way that things did go that may have gone worse. It’s been altered again very recently, and I don’t know how to cope. I feel afraid of what is to come, and with all I’ve lost, I don’t know who I am anymore, even if I am not angry at where I am.
After several years of struggling with my most notable head injury, new diagnoses, mental illness, multiple harmful relationships, and losing or having to sacrifice the use of my degree, my careers, and the ability to do many things I once enjoyed, I found myself at the onset of a mixed bipolar 1 episode with schizoaffective symptoms yet again. I was struggling with the impact of PTSD on my life and function. Also trying to answer yet-unresolved questions about the impact of COVID on my body that has led to constant physical discomfort and symptoms that left me justified in being paranoid about my wellbeing.
I participated in a partial inpatient program that helped with my mental health, but the mixed episode was stubborn. I was barely sleeping, borderline suicidal on a daily basis, and not unsure whether this would be the last run for me. I’d learned coping mechanisms and addressed my trauma more deeply. Unfortunately, when you’ve done a lot of therapy and also tried and failed a lot of medication, options become limited to stop a train like a mixed episode. I’ve had episodes lasting multiple years that were almost life ruining, and I couldn’t bear the thought of going through that again.
At the end of 2023, I was treated for electroconvulsive therapy (ECT). I had tried to avoid ECT, and any partial or full intake, for my whole life. Side effects, stigma, worry of mistreatment, and many other factors had been the reasoning, but at this point, I didn’t feel like I could let fear and pride keep me from getting care, so I did it. I only managed to complete four treatments (they recommend 6-12 to start) because of a reaction to anesthesia that caused phlebitis. That was more suffering than the treatments themselves, and the treatment was still effective.
My mixed episode was disrupted. In fact I’m largely thinking more clearly than I have in my whole life. I’m more coherent to my partners, and my moods are more regulated. I still have bipolar disorder and I am still mentally ill, but it did help. And it also changed something I didn’t even realize could change.
Since I was a toddler, as long as I can recall, I have had multiple trains of thought in my head, not just one. I had typically at least seven others aside from the one I considered the primary, and they all ran concurrently, and could interact with each other. I could ask questions and get different perspectives, but I never “switched” between them or lost time to them as I have heard about with dissociative identity disorder, so I just thought that it was “normal.”
But the more I tried to explain this to other people, it became clear that it was not like anyone else I knew, normal be damned. Each of these tracks of thought had a unique voice, and an identity that I associated with them, most associated with the originating experiences – what I referred to as my monsters under the bed – in childhood where I’d originally named thes. Some of their identities were diluted in my preteen years when I started to refer to them as a group of imaginary friends, more acceptable than hearing voices but also something that I felt the need to suppress further into teen and adult years.
I wish I had written more down prior to ECT, because the month since my treatments has made me aware that I’ve lost a lot of those details – I tried not to ever name them as an adult, but I know they did have names. I remember what I visualized them as, but it’s fading into a fog with every day.
That’s because after my second ECT treatment, when I woke up, they were gone. I don’t know if they can or will come back, which is always possible with such treatment, but for now, I am the loneliest I’ve ever been. Even if I know it’s for the best, it still has been hard to adjust to.
While those other tracks of thought were often toxic, bent with cruel and defensive and aggressive intent, and filled with unkindness to me and everyone else, sometimes they were the only kindness I had. They were the ones who encouraged me to fight against mistreatment out of spite and have some pride in what I could manage to accomplish. They were the voices telling me to get out the door anyway, even on the days when looking at myself in the mirror was nearly impossible.
They were my frenemies, for lack of a better term. The worst things I’ve experienced, and the hands that held me when no one else did. They reminded me why I chose to do things to be safe and berated me when I failed to do my best. But they were there. Always. I don’t remember a moment without them until now.
And it has been so lonely. It’s been so difficult to adjust! They were at their loudest and most present in the past few years, no longer drowned out by alcohol and encouraged by the constant triggers from the outside world. And now, I have a one track mind. I have never had a one track mind.
My ability to multitask is almost nonexistent. My coping mechanisms all need alterations to work properly. I can only hold one thought at a time and my memory wasn’t great before I got my brain zapped, so I lose track of my schedule, my belongings, and my thoughts much more easily. I don’t have anyone snapping at me to remember things, but I also don’t have the part of me that I could use to simultaneously edit texts, listen to music, chat with friends, and remember what time dinner is. I don’t know if any of that will change or rebuild.
I don’t want them back, not really. It was chaotic and frightening sometimes, and so impossible to fight against. I don’t really want to have to do ECT again if they return, but I likely will, because I know I can’t live like I had been – my brain does not have the space for my frenemies, especially these days.
My frenemies were so helpful in a lot of ways as a kid, even if they were also hurtful. But relying on them as an adult was hurting me and many people I loved. That sucks, and I wish it hadn’t gone that way. I don’t know if I could have kept them without the hurt, but I doubt it, because they were born from hurt. I don’t think they could exist without it.
I know that the road to healing is uneven. I know that change happens, and we have to grow with it. I’m trying to do that. I also have never felt so alone in my mind, so unsure about what I am doing and who I am. I feel unmoored from myself, all my tethers gone in the deep seas of my mind, even the anchors, even the ones that were dragging me down, and I dont have sails or an engine to take me to safe harbor. I don’t trust the wind and waves.
What do you do when something you felt was fundamental to your experiences, your life, your identity is just gone? What would you do if your longest known friends and nemeses, good and bad they may be, just disappeared into the ether with no note? What do you do when you are changed in essence, with no map to guide you, and no handy GPS voice to give you directions?
When people talk about hearing voices, we can be so dismissive, so stigmatizing, so cruel. I have tried not to be my whole life, but I’m sure I did it, even when talking to my own in my head. They may even have been part of the conversation, the sting to my words.
And that same stigma is why for the past few years I’ve been researching dissociative identity disorder (DID)and questioning my status, pretty quietly, even before I had ECT. After a lot of research, I don’t think I have DID, but I’m honestly not sure. Mental health is a bucket of worms, diagnoses aren’t so hard-line as many think, and frankly I have so many already I don’t know if I want to explore it much more.
I had mostly ruled out DID because I don’t switch perspectives, I don’t have any loss of time, and to my knowledge, my frenemies didn’t have outside activities or experience unknown to me. I know that when I was a teen and it was clear imaginary friends were not chill, I worked actively for some time to suppress how big the voices were and how much they were able to exist beyond our conversation. I don’t think I controlled it, I think I shoved down as much of it inside me as I could, afraid of the consequences of it got out. I did the same with my hallucinations, and my trauma.
If I personify these frenemies, if I say I feel bad for hiding them and pushing them into the tiny part of my brain they exist in, am I closer to some diagnosis or another? Or do I just feel bad losing something that was a part of me after years of trying to pretend it wasn’t there? Would they care that I grieve them?
That’s what one of my doctors said, that it sounds like I’m grieving. And since they could possibly return, that sounds kind of silly, I guess, but it does feel accurate. I feel a similar pang over lost friends, people I know who have passed away. A lower intensity perhaps, but it’s there. The way you would mourn a frenemy.
And the hard part, where it all comes together, is I’m grieving the loss of seven frenemies while I am operating alone on a one track mind. I can’t stop thinking about it, and I can’t just let it go, either. I think grieving this loss, this change, is essential to allow me to grow beyond what I have struggled through and be better, but I don’t know how to do it. I don’t know how to take the time for something that feels… most people would say “crazy.”
I don’t think I feel shame over my frenemies, except maybe for how long they ran rampant and how hard I am struggling to recover from their departure. I feel a lot of anxiety about their potential return, and the treatment that may be necessary to prevent it, and with that, some guilt that I would keep them away. They hurt me, but they were part of me too.
And now I have to figure out how to do the good things they did for me by myself, without the bad things. I don’t know how. They hated me but they loved me, too. I only hate myself, even more without their confidence and lies. I love my partners and I value my family and friends, I don’t want to ask anyone else to have to help me exist and function like they did. I don’t know if anyone can! I just don’t know how to do it alone, especially when I feel like I am so reduced in capacity by this one track mind.
It remains to be seen whether I’ll overcome this, but I’m trying. I want to be whole as I am. I just wish that the village that raised a child wasn’t just in my head.
