Alexei III of Russia

Early Life and Childhood
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The Mad King
Since the age of 17, around the time that he ascended to the throne, Tsar Alexei III has seen an entity that he has dubbed "The Red Man". The visual and audible hallucination has accompanied him for the last three decades, giving him advice. Despite this, Tsar Alexei detests the creature, and wishes nothing more than to be rid of him. The family mystic, Grigori Rasputin, advises prayer and mercury pills, which if anything worsens his condition.

Most people outside his immediately circle of family and friends are unaware of his condition, although it's generally common knowledge of his failing mental health.