Back Home
Again.
Hopefully, a more stable version of me now haunts the net. I have lots to talk about, but not net access at home currently. I’ll be writing, then going to the library or a cafe to upload.
God, but it’s good to be back.
Things To Consider Before Checking Into A Psych Unit
If you’ve never been in a position to need emergency mental health care, but are afraid you someday might be, I think there are a couple of things you need to know first.
Primarily, psychiatric wards at hospitals are designed to stabilize a patient experiencing a disturbing mental imbalance at the moment. Whether a person is suffering from suicidal thoughts, a psychotic break, or undergoing shock treatment (ECT), the psych unit is designed to deal with the immediate situation, not long term problems.
Consider a patient taken to the emergency room as the result of an automobile accident. The patient is x-rayed and inspected, then moved to the appropriate unit. They patient is mended, if possible, and then released. The hospital treats the injuries, it does not make the patient a better driver. The same can be said for the psych ward; it helps stabilize a patient currently in crisis. The psych ward does not make the patient less likely to have future problems.
A psychiatric ward is composed of doctors and nurses, not therapists. Consequently, a patient can expect medication and examination, not counseling. Fix the immediate problem, not the underpinnings.
Another thing to keep in mind about psych units is that doctors are often wrong. The units I’ve been in seem to have about a one doctor to ten patients ratio. The psychiatrist meets briefly with each patient every single day. On top of this, there are lab tests and medications to coordinate, meetings with nursing staff, and tons of other obligations. My own meetings with ward psychiatrists typically lasted between five and fifteen minutes.
For patients who already have an established diagnosis and treatment plan, this can prove problematic, because doctors need to treat what they see at the time. Diagnosing a mental illness isn’t like diagnosing a physical injury. You can x-ray bones; you can’t always tell the difference between post traumatic stress disorder and borderline personality disorder.
It’s a sad fact that psychiatrists, perhaps more than any other type of doctor, need a patient’s input for correct diagnosis. It is a sad irony they are least likely to listen to a patient under their care in a psych ward because, hey, the patient’s not rational. Doctors go by the book, and it often comes down to little things. For me, a correct diagnosis hinged upon whether my psychosis caused anxiety and depression, or whether depression and anxiety caused my psychosis. These things can take time, and a psych ward stay often isn’t long enough. Don’t be afraid to tell the psychiatrists they are full of crap.
Life as a psych ward patient (at least in the US), is highly structured. Meals are served at specific times. There are group sessions largely of no value whatsoever. You will be poked and prodded; scrutinized. If you’re unlucky enough to be at a teaching hospital, you will meet with teams of people. And all while locked up with a group of folks who are as imbalanced as yourself. You will be given pills you might not like. If you’ve ever had a drop of alcohol in your life, you will be treated like a drug addict or alcoholic.
You will be lied to by social workers. This happens all the time; it’s called passing the buck. Especially for people being newly enrolled on disability in the US, it takes time before one can get treatment for mental health issues. Family doctor care? No problem. Social workers and discharge workers will look for reasons to put you in family care, then tell you to ask for a referral for mental health. They lie on your behalf, then ask you to perpetuate the lie. Remember, a psych ward is not about helping you solve your problems; it’s all about immediate crisis intervention. As far as they are concerned, if you leave stable, they couldn’t give a rats ass if you completely fall apart the day after.
Not all social workers or case managers will lie to you, but remember that some do. Don’t be overly trusting when someone promises you solutions that hadn’t been present before you checked in. A week in a hospital may stabilize you, but it doesn’t fix your life.
Finally, unless you’ve been brought in against your will, you always have the right to leave. In the US, mental health professionals can only keep you so long without your consent. If the ward you’re in is making you worse, not better, by all means, get the hell out of there!
Psych wards can be good places. If you’re seriously considering suicide, or hearing voices, or are suffering anxiety to the point of agoraphobia, some emergency care might be in order. Just remember what the ward offers, and what it doesn’t.
Taking Time To Laugh
Lately, I’ve been spending an inordinate amount of time on silliness. Perhaps it’s the new medication, but I chock it up mostly to a desire not to have so much stress and misery in my life at the current moment. As such, I’ve been spending most of my online life at my other blog, reveling in old 80’s music and crafting utter nonsense.
I have a couple more mental health related posts in the offing, but I need to spend some time focusing on the other parts of me, rather than simply dwelling in disease and psychosis.
Look for updates a bit later on in the week. Until such time, you can find me here. Humor, after all, is sometimes the best medicine
Where I’ve Been
As I mentioned in my last comment on my previous post, I just got out of the hospital, where I spent a delightful (for various values of “delightful”) week in the local funny farm, aka the GaGa Hilton, aka the Muppet Motel, aka the psych ward.
In retrospect, I should have seen this coming. Last year, I developed a very unrequited crush, which turned into something like love. My job situation sucked, because my immediate supervisor was, to put it kindly, the evil bitch troll of death. I’d stopped taking my medications about six months previous.
For those of us suffering from mental illnesses that leave us with periods of relatively normal functionality, the meds issue is often problematic. When I’m feeling off, I swallow the pills, hoping they’ll make me better. When I’m feeling better, taking the pills is like a reminder of me inner freak; I have to take these pills to approximate a thought pattern most “normal” people have already achieved. In late 2006, when things were looking very grim indeed, and a job suddenly appeared out of the blue, I tried to put this whole mental health thing behind me.
That included running out of meds.
In all honesty, the insurance situation had a great deal to do with this; even if I’d wanted to stay on the meds, it would have been tough, given the pre-existing condition clause in the insurance policy offered by my employer. Still, I didn’t even try.
Paranoia is my most pernicious symptom. I don’t mean just the typical “do they like me or hate me?” sort of paranoia. I mean the “they’re all plotting against me and they can read my mind” type. Consequently, when my symptoms are raging and I need help the most, I’m least likely to ask for it, because I don’t trust anyone enough. Sometimes, I think the request at a person, because of course, I believe they can pick up the thought. It doesn’t make a lot of sense, but it does leave me very lonely for large portions of time.
So all my relationships, both real (like at work) and imagined (like my romantic crush) all fell apart at the same time. I retreated into my apartment and decided I wouldn’t leave it except after dark to buy food or whatever. I took to drinking heavily.
Heavily.
Like, a half-gallon of gin a week. Sometimes more, sometimes less.
I found the drinking helped block my psychotic symptoms for the short- term. I could be around friends, or even go out to get food during the day, if only I had a couple gin and tonics first.
I’d planned to really develop my blogs, start monetizing them, and be able to live off the proceeds. Not very realistic in hindsight, given my motivation level, but I hoped I could just avoid people altogether. I had some savings, so I was able to keep my bills paid at the time.
When the blogging didn’t take off, and I saw my life going down the drain, I decided I would live like the Sun King until the money ran out, then I would kill myself.
I’m not stating that to be dramatic. That’s just the way it was. I purchased a couple packages of sleeping pills, and redoubled my drinking campaign. Secretly, I think, I was hoping I’d just die of alcohol poisoning and wouldn’t have to make the fateful decision.
Doomsday, for me, was to come on February 1: the day the money ran out. A couple days before, I popped all the sleeping pills out of their bubble wrapping, and placed them in a small juice glass, which I put net to my bed. An homage to all the drunken, messy drama queens who have gone before, I guess. The night of the first, I really tied one on, wrote a messy email to someone with whom I’d had some misunderstandings, and logged off the computer.
There I sat, a glass of gin in one hand, looking at the calming, cerulean blue of the capsules intended to end my life. I reached for the glass, and found my cellphone instead. I dialed the suicide hotline.
The moment the phone was answered by a crisis counselor, all my emotions welled up inside me, and I began blubbering like a, well, blubbering thing. I couldn’t stop crying. I couldn’t stop shaking. She convinced me to go to a nearby emergency room, where I became the drunk in room 9. From there, once I’d sobered up enough to be admitted, I was taken to the psych ward; the same one I’d been in two years ago, where I received the first useful diagnosis I’d ever been given; one that seemed to capture all my symptoms, and that I wrote about in the previous post on this blog.
Same psychiatrist, different circumstances. They put me on an alcohol withdrawal watch, complete with a list of medications standing by in case I started having serious physical problems. I’m damned with an iron constitution, which in this case was a blessing, because the withdrawal wasn’t bad, if I even noticed it. I think I had itchy skin a bit, and I felt quite hot. That was the worst of it, which is very fortunate.
I can’t really blog about what went on in the psych ward. To do so would be to offer some identifying information that someone, somewhere, might stumble across and think “Hey. That was me.” I refuse to even hint at betraying such a confidential and painful environment.
I can tell you, however, that once the drunkenness went away, the psychosis came back. Part of this is due to the psych ward itself. There’s a hyperawareness of one’s illness in such circumstances. The daily meetings with the psychiatrist, the group sessions, the medication, the nursing staff: everything constantly reinforces the idea that one is sick in the head.
One’s thoughts become bifurcated: on the one hand, there is the desire to sink into a state of neediness; on the other, to run like hell. I found myself talking in a mousey voice. My psychotic symptoms returned with a vengeance. I was paranoid, heard voices and sounds that weren’t, objectively speaking, real. I was also getting help.
At any rate, I spent a week “inside”, working with doctors and nurses, trying to put myself back together. I’m better now, I think, than when I went in. I’m certainly not drinking, and I’m back on medication.
I feel strange around people. I have the urge to explain where I’ve been, and to seek out people I can talk with about what’s going on in my head. I simultaneously feel a need to offer assurance, to be the same slightly witty, sarcastic bastard with a dash of bravado that people know on the surface. More bifurcations.
My anxiety is up, but my depression is down. My paranoia is up, but so is my sense of hope. My life stressors are doubled, because now I’m looking forward to a future; a future in the short-term that will prove probably very unpleasant and full of turmoil. Still, I’m here.
What does it mean to still be here? I guess I’ll find out.
