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guidedreveries · 3 days ago

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Anti-Psychotic

A person living with schizophrenia finds that their delusions may have more basis in reality than they thought. Originally published in the Fall/Winter II issue of Diet Milk Magazine, available here. Content warnings for depiction of psychosis, violence, ableist language.

No one is watching me.

Julie has me write that down at our session. She never listens to me. She says, it can be comforting to realize that people don’t think of you as much as you think they do. I know this already. She asks, what evidence do you have that you are being watched? I say there isn’t any. Just a feeling. She writes something down, and asks about my meds again.

So fucking patronizing. Of course I take them. I have taken mine like clockwork, every day, for five years. Maybe I missed a few days, but who doesn’t forget sometimes. My meds are cleat spikes jabbing into the earth. Helping me keep my footing. Making sure I don’t slip.

Last week I started getting the prickle again. Like fingers up my back. Someone standing behind me, breathing. I live alone. When I felt it, I wasn’t scared at first. These things happen sometimes. I’ve been around the block. The prickle and I are old friends, practically. When it finds me, I have ways to forget it.

I drew the blinds, which helped a bit. I had a drink—nobody's perfect—but the prickle didn’t dull. So I peeked through the shades at the street below. Normal street stuff. The sun was setting, painting the world in shades of fire. Cars went by, all the usuals. Some kids were yelling in a driveway. A wasp tapped at my window, wiggling its feelers at me. No obvious source for the prickle. So, probably nothing. For the rest of the evening I puttered, read my book, ate some frozen nothing heated in the microwave, and took my meds. The prickle was temporary, I told myself as I lay down to sleep, the usual fog settling over me in a cool, clammy layer. No one was watching me. No one ever is.

That was a week ago. It’s only gotten worse since then. The prickle turned into a terrified stomach ache that kept me up for nights and nights. I called in sick to group, told Cheryl the caseworker that I have the flu. She sounded alarmed, but she’s only worried because of what happened to Devin.

Devin was like me: good at meds, good at therapy. We were friends, in a psycho kind of way. A few weeks ago, Devin started to get bad. Stopped showing up to group, didn’t even call. I haven’t seen him in a while, even when I went looking for him in his usual bad places. I miss him. I told Cheryl not to worry. I’m steady, just sick. I’ll see her again soon.

I keep taking my meds, but they aren’t helping like they should. The fog I count on to sleep is thin, or missing. Something scrabbles at my skin from underneath, and I keep catching myself scratching little bits off of me. When I lay down, a low, neutral voice whispers nonsense at me through the pillow I clamp over my head. I can’t shower; that’s when the prickle gets stronger. Someone standing on the other side of the shower curtain, someone looking down at me through the water stain on the ceiling. I hiss and babble out loud just to hear myself talk, to shut up the voices that aren’t mine. I get sicker by the day.

By now I haven’t been outside in over a week, but my meds are ready to pick up. I don’t want to miss a dose, so I put on shoes and the big jacket that makes me feel safe, and I go outside. Birds leer at me from the tops of buildings. Walking in the opposite direction, an old lady frowns at me.

“Hmph, same to you,” she snaps.

My stomach lurches, but I don’t say anything, just keep walking. I hadn’t spoken. Had I?

The drug store is brightly lit. It hurts to be inside. Too many things to look at. Faces on packaging look strange now. Confrontational. Interrogative. But at least they look like faces. When I look at anyone real, their features shift. Static snow eats at the air around their heads in a halo. It frightens me, so I keep my eyes on my shoes. The pharmacy tech who’s always there gets the packet for me, rings it up.

“Any questions about your medication?” he asks. I shake my head, pay with a card. He has glasses that give his face a sort of stability, so I look at it. His eyes are brown, beard gray, no hair on his head. He smiles at me. “Have a nice day, miss.”

“You too,” I mutter.

And then I go home, have to stop myself from running for safety. The walk is twenty minutes each way; harrowing, the passing cars huge and hungry, huffing and snorting at me. The prickle is more than a prickle by now. It feels like someone is pulling out the hairs on the back of my neck, one by one. My heart thuds against my ribs so hard that I’m afraid it will burst out, plop on the sidewalk and keep throbbing without me. The paper bag with my pills turns damp and tattered in my sweaty hand.

And getting home doesn’t even help this time.

Julie says too much TV can be a trigger for me, but I start leaving it on all the time. Noise beats silence, any day. No empty spaces that need filling. I can’t watch sitcoms or anything fictional, so I tune it to the news. The news is always. Steady, real, factual. There’s a story about a body they found by the freeway. Pushed out of a moving car. No one knows or cares who it was. There’s a picture of the scene, taped up yellow and covered in those little numbers that say where a bit of evidence is. A tattered jacket lays in a ditch, dark with blood.

I stand and race to the bathroom, cool porcelain against my hands, bile and nothing coming up as sweat pours down my back. My head pounds, edges of my vision sparkling. I can only see the jacket. Not dirty or bloody or ruined but the way it used to look. Devin’s jacket.

Something is horribly wrong. Men-in-black wrong. The-end-is-nigh wrong.

The prickle wasn’t imagination. It was intuition.

Someone got Devin. Who else did they get before him?

---

The next week, I force myself to go to group. I need to see faces. See who else is there, or not. Cheryl picks me up for these, since I don’t drive. I’m sicker than I can remember being, and try to remember to ask Julie about my dose on Tuesday. I sit silently in the passenger seat, feeling Cheryl’s eyes on me. Caseworkers all have the same eyes.

“Feeling alright today, X?”

My name isn’t the name she calls me. You don’t need to know it.

“Fine,” I say, pinching my hands between my knees. They shake if I don’t. “Still getting over that flu.”

“Sorry to hear that,” she says. Her sedan has beige fabric seats. The passenger seat is dark, stained with sweat and whatever else from all the people she’s ferried around. A vanilla air freshener dangles from the rear view mirror.

Someone shouts in my ear, so close I feel a little blast of hot breath on my neck, and I flinch. Cheryl looks at me suddenly.

“Everything okay?”

She didn’t hear that. “Yeah. Sorry. Weird itch.”

“Hmm.”

Group is fine. It’s usually fine. I don’t say much this time, just look around at everyone in their folding chairs. Their faces are wrong. It makes me nauseous to look, but I look anyway. I need to see who isn’t here.

There are no empty chairs, but there are fewer. One or two down from usual. All the other regulars are here, picking at their skin or looking at the clock or chewing their hair. I glance across the room and for a second I think I see Devin, sitting in his old coat. But when I look again, it’s just Tom. I almost hoped.

When it’s over, there’s bad coffee to drink. I suck on a red straw and let the bitter taste anchor me to my tongue. I inhabit my body, touch my fingers to the side of my face to know that it and my fingers exist. Sufficiently convinced of my realness, I go to Amber, our de facto leader.

She’s drinking water from a bottle with cucumber slices in it, cloudy with pulp and seeds. Ectoplasmic. It makes my stomach turn.

“Amber,” I say. My voice feels far away. She looks at me, expectant. “I missed last week. Have you seen Greg, or Mariah?”

“Oh, no, I haven��t. Greg was here last week, but I haven’t seen Mariah since like, last month. Why?”

“Just wondering.”

A crinkle appears between her eyebrows. I focus on that, since the rest of her features won’t stay put. “You’re worried because of what happened to Devin?”

“I think Devin is dead.” There is a sudden hush as other people in my vicinity overhear. “I saw his jacket. On the news.”

Cheryl appears beside me. “X, would you like to talk in the hallway?”

She pulls me out before I can answer. “Have you been feeling alright?” she asks again. “Taking your medication?”

“Yes,” I say, a little forcefully. She clicks her tongue.

“Really? Because if you need to move up your next appointment, I can make some arrangements for you.”

Despite the fact that I do want to move my appointment up, her tone hits a button in my brain and my face turns red. “No,” I say. “I’ll wait until the next one. I’m fine. I just need to know what’s happening.” A rancid taste creeps up the back of my throat. “Where are people going?”

“Honey, everyone’s here that needs to be here.”

“No—that’s not right. I need to know.”

I can tell from the way she moves that she thinks I’m getting agitated. She doesn’t understand what I’m saying. “People call in sick sometimes. You did, just last week. Mariah was having issues sticking with the program, so we’re working something out. No one’s gone.”

“Devin is gone. Devin is dead. He’s dead and no one knows it.”

Cheryl comes closer, her voice so low and venomous that it starts to meld with the others. “I’m going to give Dr. Bern a call and try to get you in with her sooner than Tuesday. If you can’t keep up with your regimen, we’ll have to consider another in-patient stay.”

Anger chokes me until my vision goes white. “Okay,” is all I can manage. I have some unsavory thoughts, which I won’t repeat to you now.

“Good,” says Cheryl, holding my leash. “Let’s get you home.”

I don’t sleep. I don’t even try. Someone is watching me. I think about Devin, the last time we spoke before he was gone. He got paranoid, too. He jabbered sometimes, when we would see each other. The same face, he said, with glass eyes. Looking at him. Following him. He said his pills were replaced, his furniture moved, nothing looked the same as he’d left it. No one listens to me, he said. I’m scared, he said. I’m scared of what will happen next.

“I’m scared, too,” I say to no one. A chorus laughs at me.

---

“So,” says Julie. “Cheryl told me you’ve been having some trouble sticking to your medication.”

“I stick to it,” I say, and set the pill bottle on the desk in front of her. “Count them and tell me I’m not.”

She doesn’t move to count them. I’d hoped at least that she would humor me. “It sounds like some of your persecutory thoughts are returning. Tell me about what you’re worried about.”

“I saw on the news that they found someone’s body in a ditch off the interstate. They showed pictures. I think the body was Devin.”

“Devin from your group?” I nod. “We actually just heard from him last week. His brother answered when we called his phone. Devin is currently in a private rehabilitation clinic in Cincinnati. He’s alright, X.”

A numb feeling falls over me all at once, like a sheet. Something crawls up my thigh and disappears into a deep hole in my flesh. “Oh.”

“Amber talked to us, too. She said you asked her about Greg and Mariah’s absences this week?”

“Uh-huh.”

“I followed up on those for you, too. Greg had an accident at home and was in the emergency room during your meeting time this week. Unfortunately I wasn’t able to reach Mariah personally, but her father informed me over the phone that her family has pulled her out of the program. She won’t be returning.” Julie leans across her desk. “X, can you please look at me?”

I look at her. Her face is twisted, like a mask, papier mâché, drooping strips of plaster bandage. The static threatens to consume her, and me.

“I’m going to increase your dose to eighty milligrams. For now you can take two of what you have at the usual time, but I’m sending in a new prescription to the pharmacy.” She scrawls something on a pad at hand, and I take the opportunity to look away. “I’ll see you again this time next week, okay? And if anything’s the matter, you can call the nurse’s hotline. We’ll take care of you.” She hands me the script.

“Thank you,” I say, and then someone brings me home. I am silent for the drive. Thinking.

Wasn’t Devin an only child?

I start doubling my dose. The fog doesn’t come. The prickle intensifies into ceaseless paranoia. I check the window locks three times a day to make sure, even though I live on the third floor. Chair under the doorknob, empty bottles stacked on it so I’ll hear if someone comes. I can’t stop thinking about Devin, and the others. Were they all really fine? Was this just a breakthrough-breakdown, pills ceasing their function and leaving me alone, spiraling?

I hadn’t tried calling Devin in weeks. He didn’t pick up the first few times, and anyone in that state doesn’t usually want to talk anyhow. But Julie said someone answered when they called. Maybe they would answer for me.

The phone buzzes. Surging forward and receding, like a tide. Devin could be there on the other end. Getting better. Being cared for. I close my eyes and wait to hear his voicemail, or something else.

Click. “Hello?”

The voice startles me so much I can’t speak. A stranger.

“Hello?” says the phone. “Who is this?”

“Um,” I say suddenly, “Devin?”

“Oh, I’m sorry,” the voice says. “Devin isn’t here right now. May I ask who’s calling?”

“I’m—his friend. X,” I clarify. My voice is not of me. “Can I talk to him soon?”

“No, unfortunately he can’t talk. But I’ll let him know you called, he’ll be happy to hear people are checking up on him.”

“What’s—who are you?”

“I’m Eric, Devin’s brother. I’m taking good care of him, miss. Have a nice day.”

The call ends. Something in my stomach shrivels. I run to the bathroom, but there’s nothing to bring up. I don’t know why that voice scared me so much. Why had I thought Devin was an only child? He hadn’t mentioned his family—maybe I’d just assumed, or forgotten if he’d said. Of course he had a brother. He was alright. They all were, now.

---

Days pass. Bugs make their homes in me. My medication runs out, the new pills ready for pickup. I’d rather die than set foot outside. But I need my stability. I steel myself to leave, and exit my apartment into the world.

Everyone looks at me. They all want to hurt me. A car drives slowly past me and I try not to look at the people inside. My head hurts. It’s hard to see where I’m going, but I go.

The drug store is bigger than it was last time. Brighter. Angrier. People avoid me as I shuffle towards the pharmacy counter. The pharmacist who’s always there smiles at me again.

“Do you have any questions about your medication?”

I shake my head, fumbling for my card. He’s staring at me through his glasses.

“Do you need me to call someone for you?”

His voice makes me want to puke. I shake my head again, take the pills and make for the door. A crowd of voices shout at me as I stagger out into the air. I miss the way things were. My cleats don’t fit anymore. I tear the bag open, pop the lid off the bottle and shake a pill into my mouth, force it down dry and sticky and hope it does its job. My mouth is sweet where it lingered. It didn’t used to be so sweet.

There is a dull shock of understanding that blooms at the edge of my mind. The prickle rises on the back of my neck, and I look over my shoulder again. The pharmacist is looking at me from his position behind the counter. His face ringed in static. He waves at me. And I take off running.

There is no one I can call. No one who will listen. There are only doors that will slam in my face, white speckle tile and fluorescent lights and needles. He knows that. He knew it for Devin, too. He knew it for the rest of them. The wind in my face feels like fingers grasping at me, tugging at my hair, slowing me down. I race home, up the stairs and lock the door, brace it with furniture and then I sit on the floor and cry and cry. They’re laughing at me. Trading whispers. Look how stupid. Look how gullible. Go on and cry, crybaby.

So I do. It’s all I have left.

The next time it’s group, I don’t come to the door. Cheryl calls me, but I don’t answer. There will be a wellness check if I don’t come. I want them to, now. When her calls finally stop piling up, I wait fifteen minutes, then step outside. I leave my door open, leave what I can to show that I am gone. I leave the pills out, and the script. Crush a few with my heel for good measure. I hope they can put the pieces together.

It’s dark, cool. It reminds me of the fog, makes me wish I could sleep. Eyes follow me through the evening. Headlights burn me as cars move past. I walk slowly in my big jacket, letting myself be watched. Letting the prickle come up my neck, creep over my scalp, trickle down over my face until it covers me in a thin layer and I prickle all over. The prickle and I are old friends. It tells me when to be afraid.

Then there are headlights at my back that don’t go away. The growl of an engine crashes into me. I stop walking, and someone gets out. I don’t turn to look. I can’t stand to look at faces anymore. Suddenly, I have a funny thought. Maybe I do have some questions about my medication, after all.

Something whistles through the air above my head, and the world disappears.

When I wake up later, I’m not sure if I have. There are stars. It smells like gasoline, copper and dirt. My jacket is gone. My mouth is gone, too. My hands. You’re caught, someone says in my ear, you let it happen. With my eyes, which I still have, I look across the floor. It hurts to look. There’s blood under me, sticky black. The prickle is gone. I discovered its source.

I’m alone for a long time. It’s hard to say how much. I realize that there’s a door behind me when it opens. Light falls across the floor, yellow tractor beam coming to take me away. I long to be weightless, but the earth won’t let me. Then the pharmacist who is always there puts his shoe against my face and turns me over. He doesn’t speak. He crouches down and looks into my eyes like he is trying to take something from me. Then he takes the tape off my mouth.

All I do at first is scream. It's all my body knows how to do. He sits and watches me. When I can see his mouth, it’s smiling, and I realize he likes it when I scream. So as soon as I can, I stop. Silence rushes back into the gaps, roaring in my ears.

“Good girl,” he says when I am quiet. His voice is a distorted growl, infrasound, rattling my eardrums. “Aren’t you such a good girl?”

I think about his throat in my teeth. I think about his blood on my face. For a moment it feels like I am lunging for him, jabbing thumbs into soft and fragile places. But he still has my hands, turning numb and purple at the small of my back. So I sit up as much as I can and spit at the floor near his feet. Faster than my eyes can track, he lurches forward. Fist in my hair, hauling me up to hip height.

He looks into my face with his glass eyes. His mouth is monstrous, all his white teeth sharp in a thicket of gray.

“I’ve been watching you,” he says.

I know this already. There is nothing satisfying in the confirmation of it.

He is not the man in black I always pictured. He could be anybody.

“Think of this as a favor I’m doing you.”

Then he hits me again. And other things.

When I’m alone, voices chatter in my ears. No one is coming, they say, you are alone. They will not find you. You and the ditch will be friends soon. So you amounted to this—better than nothing, we suppose. I shush them, rock myself against the cement floor and hum and think about grass, and birds. I try not to leave myself room to cry. I don’t want him to have the satisfaction.

A thousand years go by. Outside the room, there are voices. Not any of mine. His, and others. They start loud, and get quiet. His voice goes away completely. Doors open, distant, then closer. Light falls over my body again, and I feel the weightlessness. Real this time. My hands come back to me, but I can’t move them. There are faces, more than I’ve seen in a while. They scare me, but I can’t run, so I try not to look. Except at his. They take me past him, and I look. Through his glasses I see his eyes, still trying to take something from me. He has, by now. But not what he wanted.

I sleep for a long time, and when I wake up, the world is the way I remember it. My feet on the ground, cleats and all, not slipping. When I’m well enough they bring me to identify Devin’s body, since he didn’t really have a brother after all. They find Mariah’s, too. Greg really was in the emergency room, turns out. But there are others. Too many to think of.

Cheryl changes careers afterwards. Probably for the best. I find this out when she drives me to group the first time after I get out of the hospital. She doesn’t look at me much, but when she does, I can see her eyes are different. Not caseworker eyes anymore.

“Lauren is going to be taking over your case starting next week,” she says after a long silence. “So this will be the last time I see you.” I can tell she’s trying not to cry.

“Okay,” I say.

She never apologizes. No one does. They all say they’re sorry for what happened to me, but that isn’t the same thing. People who don’t listen never think to apologize for it. They think they were listening all along.

Things are mostly the same as before, except I get my pills mailed to me now. And I think about Devin a lot. When I pour myself a drink, I pour one for him too and pretend he’s with me. I don’t have any pictures, so mostly I think about his voice. The last time we ever spoke, he told me, no one listens to me, X.

What I said then was, I know the feeling, man.

But now I just tell him I’m sorry.

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