A Tale of Two Faces: Discovering, Accepting, and Living with Mental Illness

by Tiffany North

Listen to Executive Director Gabriel Nathan read this post aloud:

For as long as I can remember, I have not known how it feels to be emotionally stable. By age thirteen, I became accustomed to the frequent highs and lows, and had unknowingly curated the perfect mask for every situation. Although social interactions were awkward, I was able to blend in, oftentimes by becoming selectively invisible.  Even when mimicking the moods and mannerisms of those around me, I knew that there was something that set me apart from my peers. Happiness. I was never truly happy. It’s not that I never experienced elevated moods, but my baseline was, at best, neutral.

As I continued to drift through life’s ebbs and flows, it never occurred to me that the average person didn’t live in their head. Each day wasn’t meant to be lived with endless loops of racing thoughts, major shifts in mood or constantly feeling on edge. Clenched jaws and a tight chest didn’t strike me as abnormal. What did, however, was how everyone seemed so unbothered by what I thought was the ordinary human experience. The lack of happiness that I initially thought set me apart from my peers paled in comparison to the reality of what I had been living with.

At thirty-two, my mental health took a drastic turn that eventually led to a comorbid diagnosis. In 2020, I endured a postpartum manic episode that was quickly accompanied by psychosis. This experience lasted for a little over three months, and consequently changed my life. I was taking antidepressants toward the end of my third pregnancy, something that I never tried before because cyclical depression was normal. After my son was born, I had been medicated for close to five months, at which point I began to feel euphoric. The sadness and anxiety that had sent me into a downward spiral began to ease at a rapid rate. It felt as though nothing could harm or impact me negatively, cultivating a false sense of impermeability.

Euphoria led to embodying a confidence bold enough to make me believe that I could ditch the “happy pills” as I came to call them. I had an uncanny amount of energy, especially for a mother of two toddlers and an infant. I would spend hours awake at night and was still able to begin my day at four in the morning. I slowly began to lose weight because I was rarely hungry. Instead, I was living off of caffeine and the occasional snack assuming I remembered to eat. I was completely unaware of the consequences of discontinuing my medication due to a lack of information and follow-up care. Although, looking back and considering all that I know now, I’m not so sure that would have prevented mania and psychosis anyway.

Because my husband was working long hours and my symptoms hadn’t yet caused any disruption in our home life, he didn’t realize that there was anything serious going on with me until after they became more severe. There was a brief transition from an elevated state of mind, to a complete severance from the real world. Psychosis seemed to have developed overnight, and I wasn’t at all aware that my thoughts or actions were any cause for concern. I began to hear voices that were comforting one moment, and commanding the next. At some point, these voices had convinced me that I had both an earthly and a spiritual identity. On the one hand, I was a typical wife and mother but, on the other, I existed on this plane as some sort of spiritual entity. These symptoms would present with the same narrative during a future psychotic break. I was halfway gone by the time my son turned three months old, and living in a universe so different from reality that, in hindsight, was reminiscent of an apocalyptic movie. It truly is a wonder I was able to continue to care for my children while my husband was working such long days.

According to my medical records, it had been a solid month of mania and the psychosis that followed before I called 911. I remember being afraid that I would die by my own hand. It wasn’t that I had concocted a plan to carry out, or even that I wanted to do it at all; but the haunting feeling that I wouldn’t make it through the night is what prompted me to call for help. After twenty days in an inpatient facility, I was released in what was deemed a state of stability, only to experience another episode of psychosis; much worse than the last. Shortly after returning home, what I thought was an intense fear of taking medication, led me to abruptly discontinue the antipsychotics that I was prescribed. I would later find out that each incident of psychosis was the result of the medications themselves, not because I stopped taking them.

For the second time, I experienced auditory hallucinations that were eerily familiar to the voices that I had heard before. Again, I believed that I had multiple identities, combined with grandiose delusions and impulsive behavior. I also exhibited extreme paranoia and rage, and thought everyone, except for my children, wanted to kill me. There are many verbal interactions with family and friends that I still don’t remember, and honestly, I’m grateful that I don’t. As severe as things had gotten, I don’t recall seeing a psychiatrist but once virtually. I can also faintly remember speaking with a therapist, but I am not entirely sure what progress, if any, was made. From what I now know about this episode in particular, I refused additional care because I was afraid to be admitted again. Instead, I tried my best to ignore the voices, anger, fear and the other feelings that had all but consumed me. A few months after that final episode, and as the symptoms completely subsided, I began to feel more like myself. As each day passed the symptoms of psychosis slowly began to decrease as my body adjusted to the absence of medication. I noticed that the voices had suddenly disappeared, and most of my fears along with them. I steadily regained mental clarity, and the thoughts that once felt out of my control were mine again.

Even though I was feeling better, I knew that I would eventually need to address everything that had transpired. It took about a year for me to admit to myself that I needed help picking up the pieces of the previous year. I found a therapist who was a Godsend. I felt validated and understood, but after a year of working with her and making quite a bit of progress, I reached a plateau. One session I was content and optimistic, then a few weeks later I would be drowning in tears feeling hopeless and alone. After all of the time and effort I invested in my mental health, I still didn’t understand why I was so up and down emotionally. I finally hit a breaking point. I knew that I was struggling with more than postpartum depression, but I wasn’t confident in the diagnosis I was given during inpatient care. So, I fought through the trauma of having been medicated and all that came with it, and reached out to a psychiatrist. Another Godsend. After two appointments I received an official comorbid diagnosis, and we dove right in and developed a treatment plan.

After starting the proper medication, it took quite some time for me to come to terms with what I had been living with unknowingly. ADHD caused a lack of focus, making it difficult for me to be productive, follow through with plans, or pursue the goals that I wished to accomplish. Being under immense pressure was one of the only conditions that compelled me to focus and execute tasks to completion. This also explained why I would become so easily overwhelmed and overstimulated, which oftentimes resulted in shutting down entirely. OCD prompted me to perform rituals in order to ensure the safety of myself and my loved ones, such as repeatedly checking that all doors were locked and appliances turned off before bed. Engaging in these actions created a sense of security, temporarily giving me peace of mind. Generalized anxiety caused intrusive thoughts that could have easily been the plot to a horror film. For much of my life I would entertain these scenarios, thinking of solutions to a set of circumstances that had not, and more than likely would never take place. Last, but far from least, the game changing diagnosis of having bipolar type II is what caused depressive episodes that came without warning, and circled back around before I had the chance to fully regain my footing. Interestingly enough, this diagnosis is what is now believed to have been a factor in the mental condition that temporarily derailed my life. After beginning treatment with my psychiatrist, I learned that taking antidepressants in the absence of a mood stabilizer can greatly increase the risk of mania and psychosis in patients with mood disorders. Because I was unaware of my bipolar II diagnosis, I was highly susceptible to that risk.

I spent a lot of time trying to understand the how’s and why’s behind all of it. I felt anger, resentment, and confusion; but most of all grief. I grieved for the young girl who spent so much time in her head trying to create a reality that made her feel better than her own. I grieved for the teenager who wondered why her emotions always seemed to get the better of her even when she tried so hard to gain control of them. I grieved for the young adult who tried to navigate life and relationships while constantly feeling overwhelmed, inadequate and disappointed in herself. Lastly, I grieved for the thirty-two-year-old who had to experience some of her worst days because of her lack of knowing.

I am much better now. I’m stable. I can think clearly. I can set attainable goals that I feel confident in achieving. Still, with all of the growth that has come with stability, I am still in the process of discovering who I truly am apart from all of the masking, the adapting, and the blending. It can be hard not to feel like a stranger to myself some days, but now I can find comfort in knowing. Knowing is what keeps me grounded, and it has led me to find a purpose greater than anything I could have ever found myself capable of pursuing.

​EXECUTIVE DIRECTOR / EDITOR: Gabriel Nathan | DESIGN: Leah Alexandra Goldstein | SITE ORIGINATOR: Bud Clayman