My Relationship With… Voices and Anti-Psychotics

CW: Mental illness, Depression, Psychosis, Suicidal Ideation, Antipsychotic Medication

It’s always felt taboo saying ‘I hear voices’. I feel ashamed of it, despite knowing that I shouldn’t be. Yet, it’s there. I rarely talk about it, most of my friends don’t know about it but my family have to. Apart from that though, it’s just me and the three voices I hear.

My first experience was when I was 10. I was a little boy, hankering to one day be a film-director, perhaps a scientist, possibly a teacher and maybe even a hairdresser.  I sadly ended up being bullied. As the bullying worsened, so did my mental health and I ended up in therapy, followed by an intermittent battle with depression for the next 11 years, and my first experience with voices.

My first voice was a nameless woman. I didn’t know anything about her except for the fact that she called herself my ‘friend’. During the peak of the bullying, she actually helped me push through some hard days and I was grateful to have someone who felt like they understood me. Sure, at times her advice boarded on sadistic extremes of revenge, but in the moment it felt like someone was on my side.

Thankfully the bullying didn’t last, and like most imaginary friends are supposed to, she disappeared. I never really thought much about her or hearing voices because I was always told I had imaginary friends when I was younger. I just thought that it was normal. That was until I turned 14 and she reappeared after I started to struggle with depression again, but this time with a new agenda and a name: Madeline.

At first, Madeline scared me, driving me into isolation and locking down my feelings. I shielded her like a dark secret, but that just gave her more power, and my health quickly spiralled. ‘You’re worthless, you have no purpose, you’re better off dead’ were all phrases recycled by Madeline into insults that my brain struggled to process as I tried to hide my struggle. It wasn’t until I ended up in hospital that I realised my way of coping wasn’t working and I needed to open up.

Surprisingly, the first thing my psychiatrist said to me was ‘I’m hardly surprised. In fact, I was more surprised that you said you weren’t suffering from these voices.‘ At that moment, I felt as if a burden was lifted. That’s not to say that this was the turning point for me, because I became a lot worse before I got better, but in talking about this secret it helped me feel like I wasn’t entirely on my own. With surprising efficiency, I was diagnosed with psychotic depression and assured that once the depression was under control, then the voice would finally go away. Granted, my diagnosis at this point was wrong, but it was something to provide some hope.

I suffered from Madeline as my primary voice for four years. However, when I reached my eighteenth birthday, my psychotic symptoms worsened, despite my depression improving. What came about was two new voices, each with their own personalities and names.

The first was Nancy, a woman insisting she was my mother in another life and that I needed to ‘wake up’. She rarely makes me feel depressed but she causes major episodes of disassociation. Despite that, I consider her my easiest voice – the one that’s easiest to hide and causes me the least amount of distress because I have coping strategies that mostly work in dealing with her. I know that when I start to dissociate I need a strong sensory stimulation like having an ice-cold shower or eating extremely spicy food. It grounds me to the world around me rather than the one Nancy constantly alludes to.

My other voice is Abigail, who is the hardest to cope with and thankfully appears the least frequently. She’s the embodiment of hatred, and where I avoid confrontation as a rule, Abigail strives for it. We are opposites, and so whenever I hear her voice rising in my mind I know I need to get home. Abigail is the voice that most people can spot when I’m struggling with. I avoid eye contact, lose concentration, become jittery, pull at my ears as well as other things as my whole body becomes a reactive process of trying to retain normality as a war rages between me and her. It’s unbearable, and the only coping mechanism I’ve discovered when dealing with Abigail is to seek solace in my bed and isolate until she finally ebbs away.

Luckily, voices are my only hallucination. I’ve suffered from voices for more than a third of my life, and for a long time, I was told they would go away when the depression was sorted. That put me in a catch-22 when my voices became the source of depression, the two illnesses apparently feeding off each other as a misdiagnosis haunted any chance of getting better. That was until adult mental health services decided to class my voices as a separate entity, and tried treating them with antipsychotics.

Risperidone, olanzapine, quetiapine, aripiprazole, and amisulpride are all the medicines I’ve tried. Risperidone and olanzapine were the first and were ineffective. Quetiapine worked wonders, but it also made me sleep 16-18 hours a day. I wanted to get rid of my voices so I could make the most of my life, but weighing that amount of sleep against the voices, it wasn’t worth the trade-off. Aripiprazole worked wonders but did the opposite of quetiapine, causing extreme insomnia. While taking it I felt great, but a UTI and some other immune system hiccups later suggested my body wasn’t coping. Amisulpride was the last one I tried, and it worked somewhat, but not enough to justify the symptoms. I struggle with body image issues and when a tablet’s symptoms include ‘breast enlargement for men’, it was clear that this tablet was not the one for me. Currently, I’m in a transitionary period between medications, and while it remains unclear what I’ll take next, I’m hoping it will be the one that strikes the balance between side-effects and managing my psychosis.

I’m aware that I’m not going to find a pill that solves everything. Anti-psychotics come with a host of side-effects, and I’m happy to accept them as long as the trade-off is reasonable. I currently take anti-depressants that make me tired and sluggish, but the trade-off for having more good days than bad ones is undeniably valuable.

It’s still a struggle though. Coming to university isn’t easy for anyone. I didn’t have my family and I don’t open up to friends because I’m not confident enough to talk openly about it. I’ve learnt from experience that either people won’t believe me or they just don’t know how to respond. The latter is preferable but luckily I’ve found friends who I feel willing to open up to and who try and make a difference. And while I’ve spent a long time normalising aspects of my life, this just isn’t one that I’ve succeeded with yet. However, I’m trying. My relationship with my voices and anti-psychotics is complicated, but it’s one I have faith will get better one day.