psychiatric hospital

What do you do when you’re not okay?

It’s almost as if “how are you?” has become a rhetorical question. We ask, but do we really want to know the answer? Unless, that is, the answer is, “great, everything is going great,” no, we don’t really want to hear the answer.

What are we supposed to do when we have the wrong answer to that question? What you do is, you lie. You say, “I’m fine. Everything is good, kids are good, work is good, I’m good. Great, in fact!”

I’ve become a liar. I don’t consider myself a dishonest person, but I lie every single day. I lie to everyone. I lie to those closest to me and I lie to the clerk at the grocery store.  I spend all day lying about being ok. “I’m good, how are you?”

I am not good and I’m not even okay. But I have no choice but to keep lying. Why? Because nobody wants to know that I’m not okay. They don’t know what to do any more than I do. And people don’t like to be faced with situations where they don’t know what to do. So I keep lying.

I tried not lying last summer. I told the truth. I told my estranged husband, my mom, my sister, my kids, my friends that I wasn’t ok. And I ended up in a psychiatric hospital for 8 days where the first order of business was to remove the underwire from my bra for fear that I might harm myself with it.

I don’t blame anyone for the fact that I ended up in the hospital. Before I was a patient, I had no idea that when you get sent to a psychiatric hospital (or at least the one I ended up in) you don’t get the help you need. You get sharp objects confiscated, you have to remove the drawstrings from your clothing, you are given coloring pages to pass the time, you get woken up every two hours during the night with a flashlight in your face, you live in a room with the windows covered and are only let outside when the nurses feel like letting you outside and the highlight of the day is ‘activity time’ when you get to make bracelets out of large plastic beads that are often found in preschools. But the one thing I needed the most, I didn’t get. I needed help and I needed it desperately. I begged for it. I asked every day to talk to a therapist. You’d think the place would be filled with them, and you’d be wrong. There is one psychiatrist who sees every patient in the entire hospital for about 5 minutes each day. He doesn’t offer therapy, he doesn’t ask you how you are or tell you how to get better. He looks at your chart and sees that when you got spit on by another patient that morning you asked at the nurses’ desk for anxiety meds and that means that you are not yet stable enough to be released. File closed, see you tomorrow, maybe. If he gets tied up with too many intakes you might not see him until the day after.

With so many high profile suicides in recent years, we have all become “suicide aware,” and we know what to look for in our friends and family. We know that we need to check in with our friends and family members who are struggling. And we know that when they say that they aren’t okay, we need to do something. It’s just that there is no good “something” available.

My doctor, my therapist and every other single person I have walked with on this path through the world of mental illness tells me to immediately go to the ER if I feel like hurting myself. Seems like solid advice. But I tried that. And after two stints in the psychiatric hospital, three rounds of IOP (intensive outpatient program) and six months of DBT (dialectical behavior therapy where each week I had 2 hours of skills training and 1 hour with my individual therapist) I am still not okay. The only difference is that now I know not to tell anyone I’m not okay. And as an added bonus, I can no longer legally purchase a firearm (upon my discharge from the hospital I had to sign the paperwork informing me of the law that anyone who has been involuntarily held on a 5150 cannot purchase firearms). Doesn’t matter that I have never ever threatened to hurt anyone but myself, I am considered too dangerous to own a gun. Oh, and besides the whole gun thing, I also have a case of PTSD and have regular nightmares about being locked in a mental institution without any options for getting out.

When I bowed out of one of the celebrations for my daughter’s upcoming college graduation —  because my former in-laws told me that, even though they never called or sent me a note while I was there, I caused their family a great deal of pain when I ended up in the hospital. They have since refused to speak to me and won’t answer my calls — my husband (who is only still my husband because the divorce is not yet final after nearly two years) accused me of ruining the event. When I explained to him that since it was completely ok with my daughter to miss this ONE event, I had decided to do what was in the best interest of my mental health by not being there. He then accused me of making the whole weekend about me and refuses to speak to me.

What can I possibly do that respects this milestone in my daughter’s life and also takes into account that being around people who have told me they want nothing to do with me is extremely triggering? I suspect that is another rhetorical question. But I do so wish there was a good answer. And I wish I knew what to do when I’m not okay. And I wish there was another viable option for making me feel better. Because now I know all too well what doesn’t help when I say that I’m not okay.

Fear and loathing in the psych ward, Part 2

Here’s part 2 of my dreadful experience in a psychiatric ward. If you haven’t read part 1, you might want to go back so this makes more sense….

I sat down on my tiny bed that was bolted to the floor, next to my nightstand — also bolted to the floor — when Susie (not her real name) the nudist from a few minutes ago, walked in, and, again took off all her clothes. I watched in horror as she walked towards my bed and sprawled out ON TOP OF ME. Bewildered, I calmly told her this wasn’t her bed. Without missing a beat, and without opening her eyes, she went back to her own bed and opened her legs spread eagle in my direction, graphically demonstrating to me her preferred waxing routine. I ignored her, hoping she’d stop. Thankfully, a nurse appeared in our room and told Susie to get dressed. She helped Susie into her shirt and turns to get her pants. Immediately, the shirt comes back off. This goes on for a few minutes until, finally, Susie is fully dressed.

A little while later (time feels very non linear in Sequoia Unit) Susie walks up to the nurses’ station and takes off her pants. Everyone comes out of the activity room to watch.  Sherri (Also, not her real name. Actually, let’s just assume that from here on out, all names are made up), realizing that I’m terrified by my roommate’s antics offers to let Susie have her private room and she would move in with me. She didn’t “feel safe” in her room since it was too close to the emergency exit. Thank goodness for Sherri. A nurse comes in and fully sanitizes the vinyl-covered mattress and puts a sheet and a thin blanket on it. Sherri tells me that our toilet is clogged and then goes to inform the nurses. Just a quick note to say that the bathroom has a “door that is just a vinyl panel, secured with velcro that is no taller than a public bathroom stall door.

Back in my room, and with nothing to do, I looked at my discharge paperwork from the hospital. Tuns out it wasn’t discharge paperwork, it was an “Involuntary Patient Advisement” which declared that I had been 5150’d. Under the line, “we believe this to be true because…”  and, in quotations, it read, “you’re going through a divorce, upset and overdosed. Several prescription pills (Ativan, .5mg about 30 tablets) with alcohol to end yourself.” Wait, what? I don’t even HAVE 30 ativans — my doctor very specifically only prescribes them 15 at a time. So, yeah, I call bullshit on that. “End myself?” Really?? Look, I apparently said and did a lot of things that night that I don’t remember, but I’m pretty sure that I said nothing about “ending myself.” If I wanted to “end myself” I sure as hell would have come up with a more grammatically pleasing way to state it. You can accuse me of a lot of things, but I would never say anything as clunky and ridiculous as “end myself.”

I marched down to the nurses’ station and insisted I speak to a doctor to explain that I did not, in fact, attempt suicide and, more importantly, would never say that I wanted to “end myself.” For some reason, this seemed very important to me at the time. I was told that the doctor was suffering from a migraine and they would let him know I wanted to speak to him, but it might not be until tomorrow. I asked if I could see a social worker. She was gone for the evening. Fuck. Dread started to set in when I realized I was essentially trapped in Sequoia Unit. And my toilet was still clogged.

I asked the nurses what I was supposed to do. “There are coloring pages in the activity room.” I’m 50 years old, I don’t do coloring pages, unless it’s an artsy adult coloring book and I have expensive, fancy markers. “Are there any books?” I asked. “No, but there are coloring pages.” “Is there paper so I can journal?” Hallelujah! They have journals! “Can I have a pen, please?” I was handed a short, dull pencil — the kind you get at miniature golf. “Can I have more than one pencil?” “Come back when you need another one.”  Great. 

In addition to a lot of weird habits I have, I am addicted to lip balm. It’s a thing, you can google it. In the loony bin (which, now that I’m distanced enough from the experience, I can call it that. It’s the only way I can really cope with the experience. And I fully accept that I am loony and please don’t tell me I’m discriminating against the mentally ill….I am mentally ill) chapstick is not allowed. I really can’t think of any logical reason for this, but it’s a rule in Sequoia unit. When I asked for chapstick, they gave me a miniature-sized one — like smaller than I ever thought possible. I think it was about and inch and half long. The nurse told me I could use it while at the desk but had to give it back afterwards. She would put a label with my name on it and I would have to come ask for it whenever I needed it. After asking for it five times in the span of 30 minutes, the nurses started pretending not to see me when I approached the desk. Once, when using my chapstick, Susie showed up and started yelling at the unit’s psychiatrist, calling him, inexplicably, a “fish head” and insisting they give her back her belongings, since she was “ready to go out for the evening.” When they refused, she yelled that they were “holding her diamonds and pearls hostage.” The distraction was the perfect opportunity for me to casually walk away with my chapstick in the pocket of my paper shirt. 

I’m not sure what medical reason dictates that windows of a psychiatric unit be blocked from natural light, but there was a thick film on all the windows on the unit. I cold tell whether it was day or night, but had no idea if it was sunny or overcast. There were also no clocks anywhere on the unit, except at the nurses’ station. It really felt like I was in prison. And I was terrified. 

I arrived on the unit after dinner so they gave me a decently tasting turkey sandwich and water. Then it was time for medications. I received my typical dose of antidepressants, an ambien so I could sleep and then a muscle relaxer. I explained I didn’t need a muscle relaxer since I was not in any pain. The nurse kept pushing it towards me. I refused, but then she handed me a Gabapentin. I told her I didn’t need that either. She wasn’t giving up as easily on that. “Take it, it will help you get better. It’s for your stress.” I was finally able to get away with just my regular meds, but was confused and alarmed by the attempt to over medicate me. I started to suspect that they preferred the patients to be somewhat sedated. It certainly looked that way

Thankfully, the Ambien did what it’s supposed to do and I slept through the night, despite the fact that the room — and, actually, the whole unit — was kept at a bone-chilling temperature. 

I woke up in the morning to a nurse who needed to draw some blood and take my vitals. I had not idea what times it was, because, no clocks. Afterwards, I went to the nurses’ desk to get my chapstick and was handed my my breakfast in a to-go container with a paper cup of cold decaf coffee. Breakfast was also cold and unappetizing. It includes a bowl of Raisin Bran, but I’m only given a plastic fork to eat it with. Great, I thought, at least I’ll lose weight while I’m here. And my toilet was still clogged.

After breakfast a nurse announced to the unit that it was time for the art activity and we would be making beaded bracelets. With nothing better to do, I followed the group to the door of the unit. A nurse stopped me and informed me that I was confined to the unit until I had been there for at least 24 hours. With a sense of dread, I realized this was really, truly prison.

There was a phone on the wall in the hallway that was for patients’ use, but I didn’t have my cell phone and I stopped memorizing phone numbers in 2005. I was feeling panicky and claustrophobic, I needed contact with the outside world. When the phone was finally free, I tried a few numbers that I thought might be my daughter’s. On the second try, I reached her….yay! She and her brothers were fine and happy to hear that I was okay. My daughter and 18 year old son were planning on coming to visit that evening during visiting hours (visitors had to be 18 or older so my 15 year old would not be able to come) and would bring me some clothes. Most importantly they said they could bring me a sports bra. I couldn’t wait until that visit! Visiting hours were 7pm to 8pm, I had no idea how I was going to make it that long.

Lunch is served, again, in a to-go container because I’m still not allowed to join my unit in the cafeteria. It’s some sort of teriyaki chicken breast with rice, but since I’m only given a plastic spoon, I’m not able to eat much.

At some point during the day, I don’t really know when because time is a tricky thing in Sequoia Unit, I meet with Dr. Sharon. He seems nice and I learn that he lives in New Mexico and commutes to the hospital each week. He seems overwhelmed and it’s not surprising considering there are 22 of us listed on the white board at the nurses’ station and he is overseeing all of our care.

I talk to him and he believes me when I tell him that I did not attempt suicide. He understands but is still concerned at my combination of Ativan and wine, telling me that it could have stopping my breathing. He’s worried that I still have access to more pills. After a few minutes of talking, he explains that this may not be the appropriate place for me and that he thinks I would be better off keeping the appointment I have scheduled for the next day with my therapist. He also tells me that it was wrong to have confined me to the unit and that after our meeting, he would release me from my unit restriction and  I would be able to meet up with the rest of the patients in my unit for “patio time.” During our conversation he kept apologizing for his pauses as he was still suffering from a migraine. Finally he said, “you really don’t belong here and I’m going to fill out your release paperwork and you can go home tomorrow at 9am.” I wanted to hug dear, sweet, overworked, migraine suffering Dr. Sharon!

Ok, I’ll stop here for today and will continue my story another day. Thanks for reading.