-Third's Pov-

Spain, France, and Romano were in the vents after narrowly avoiding the Psycho that was lurking around the lodge.

Spain: Finally, we got away from him.

France: I agree mon ami. But he will show up soon so let's not get our hopes up...

Romano:...

Spain kicked the vent's fence open and they climbed out.

Spain then notice that Romano wasn't talking at all since they separated from China and France.

Spain: Lovi?

Romano looks up at him. He had this doll-like look in his eyes that almost made Spain want to hug him.

Spain: A-Are you okay?

Romano cringed. Spain wanted to retort at the dumb question. Of course he was not okay! I mean look at him, he got kidnapped and was forced to watch another nation die in front of him.

And what's worse. His fratellino is missing along with Germany. No one even knows what happend to those two.

Spain wrapped his arms around him again.

Spain: It's okay. We're going to find Feli and the others. Don't worry.

Romano:...How can I not, you bastard...? He's my brother, dammit...

Spain: I know...

France: Let's just look around our new surroundings. We could find something to help solve this mystery.

Spain nods while Romano groans a bit.

They leave the vent and check out the room they were in. It had lights, lockers, posters, and other things that caught their interest.

France: Hey...What's that?

What France had found was a cork board with blueprints on it.

It looked like the Psycho had something in plan.

Spain: Amigos. I think we just stumbled upon the Psycho's true lair.

Romano: Way to point it out, Captain Obvious!

France checkout the blueprint. It seem to show stick figure of victims tied to chains while a blade is showed to get ready to cut them in half.

Spain: Oh...This is what happend to England...

France:....

Spain: Sorry Amigo...I know how much you care for him...But I wanted to save Romano and-!

Before he could finish his answer, France hold his hand up as a gesture for Spain to stop talking.

France: I know. Just please...Don't say anything.

Spain:...Okay. (France really is going through a lot...I'm so sorry Amigo. I'm sorry...)

Romano:....

France then saw something on the table where the lights are turned on.

He walks over to it and seems to see a cover page on psychiatric report.

France: Strange...this report seems to talk about Angleterre.

Romano: Huh?

Spain: Eh...? Why?

France just shook his head. He have no idea. He's about as clueless as they are. He never knew England was on medication. Maybe...He took America and Canada's disappearance really hard than anyone could even had.

But England wasn't the only one. France did too. Canada and America were like sons/little brothers to him. Losing them to that dumb prank struck a hole through his heart.

Romano: I say we should open it up.

Spain: Romano! T-This is privacy!

Romano: Do you think I give a fuck?!

France sighs before opening the cover page.

Cover Page

OCEAN VIEW HOSPITAL
HEALTH AND HAPPINESS

Arthur Kirkland

FINAL PSYCHIATRIC EVALUATION

05/21/2014

DR. A. HILL

CONFIDENTIAL

France: Angleterre went to go see a therapist named Dr. Hill? How come I'm just know finding out.

Spain: Well...He always does be secretive about his problems.

France: Don't we all?

Spain stayed silent and nods. He had a point there.

France begins to read the physician history.

Physician History

06/11/2006
Jeremy Harris, MD
Whale Point Surgery
Referred on 04/02/2007 after incident at school

04/26/2007
Oliver Purkiss, MD, MPH
Pastoral Wellbeing Center
Referred on 10/19/2009 after incident at school

10/23/2009
Roisi Williams, MD
Santa Buena Medical Center
Referred on 12/09/2008 after disagreement over treatment

01/03/2010
Sarah North, MD, PhD
Cranleigh Hospital
Referred on 11/29/2013 after patient's response to drugs tapered badly

12/19/2013 - Present
Alan Hill, MD, MPH
South-Western Psychiatry
Referred on 03/14/2014 due to potential suicide risk

History of Prescribed Antidepressants

Fluoxetine (06/18/2006 - 01/24/2010)

Patient reported that side-effects (headaches, nausea) were becoming too severe, and wanted to change drug.

Duloxetine (02/13/2010 - 11/01/2013)

Patient claimed that the drug was no longer having any effect. Reported that his mood had badly worsened.

Amitriptyline (11/29/2013 - 04/05/2014)

Patient began self-medicating, taking stronger doses.

Phenelzine (04/15/2014 - present)

30mg dose. Twice daily, increasing to three times daily after 2 weeks.

If the patient reports any of the following symptoms, please contact a physician IMMEDIATELY.

Side effects: hypotension, blurred vision, dizziness, insomnia, vomiting, diarrhea, muscle tremors, liver damage (hepatitis).

On withdrawal: nausea, insomnia, nightmares, agitation, hallucinations, paranoia, aggressiveness, slurred speech, ataxia, catatonia, shocks

Summary of Treatment

Patient arrived delirious/confused. Strong symptoms of major depressive disorder, related to death/disappearance of brothers.

Placed patient under observation.

ECT was considered, given patient's history of tapering drug effects, but rejected.

CBT, IPT, psychoanalysis, etc, failed to produce any improvement.

New course of drugs was necessary.

Patient moved onto a non-selective MAOI. Rationale being that SSRIs and SNRIs have proven ineffective in the past.

Phenelzine 60mg initially. Higher than average dose was necessary to see reduction of symptoms.

After 2 weeks, patient's symptoms and mood were greatly improved.

Discharged on 16th May after final consultation proved satisfactory.

-Dr. Alan Hill

Romano: Well...Shit...

Spain: This is...shocking...

France only nods. Why would the Psycho have something like this...

This clue had foreshadow the diminishing sanity of England,
as he starts suffering some drug withdrawal effects.

The drugs that were prescribed to England are all focused around serotonin, a kind of neurotransmitter.

Depression can be triggered, if there is a decrease by the production of serotonin. It probably was triggered by the death/disappearance of the North American Brothers.

The drugs that England took were very effective, but for his depression only, and never was effective for his suspected second mental illness, Schizophrenia. But it was overlooked and the illness was actually Major Depressive Disorder.

Was the Psycho hiding something that they're suppose to know?

If yes, then why does all of this have to do with England?