You are not your diagnosis
Bipolar One, Two, Schizoaffective disorder, Post Traumatic Stress Disorder. Whatever ails you, it doesn’t matter. They all are just diagnostic names in a manual to a clinician it feels. The dark isolation that creeps in slowly. Losing pleasure in things, stopping listening to music, even stopping working. Diagnosis aside, we all experience these and when we do it’s time for help.
Have you ever felt like the system you surrendered yourself up to for help was ill-equipped? I’m going to lead you up to and through my most recent institutionalization. It was voluntary. Not every admission I have had has been voluntary. I would contest that most of my admissions were involuntary. I want to make this distinction because I think it is important to note the treatment received should be correlated to the fact that I elected to enter into care for mental health treatment. Not criminal holding.
My own worst enemy
I am in a black hole. My emotions are gone. I am gone. Obliterated in a cosmos of vodka and depression I drown in my misery; catatonic. When the vodka wears off enough for my senses to gain hold of the reins in my brain I slowly regain my sanity. I fish for the bottle’s handle in the darkness of the crisp, freezing air of the room. The back of my wrist wisped away the cover and the bottle tilted over effortlessly; Indicating it had little to no contents. I knew I did not have the strength in me to get to the store to restock. My body was wracked from weeks of drinking 2 liters of vodka a day.
I was experienced at withdrawal, but I wasn’t concerned about detox. I was concerned about my mental state. As someone with Bipolar 2, I am prone to extreme mood swings. I can have really big ideas that can be borderline dangerous. Or, I may want to bite off way more than I can chew in a project; Or even a fight. This is mania.
On the literal flip side: the depression. I am sucked down by an anchor tied to my throat, evaporating my aspirations by draining my energy, filling my head with horrible intrusive thoughts － the worst, to some, being thoughts of self-harm. This is depression.
Combine the two of them and you get the constant struggle that is Bipolar in a nutshell. Whether it’s One or Two depends mainly on how you cycle. I suffer heavily from depression. My mania comes in bouts but is less severe than the depression and less lengthy. I think we later will come to find out that a lot of my anger that was associated with my mania is actually Borderline Personality Disorder, but at the time this was not a diagnosis so I will not include it.
I knew my only choice was to seek help or spiral out of control. I had been involuntarily hospitalized numerous times in my life. Countless even. That’s a lie. I have to count them for the courts all the time. My point is, the list is dizzying. “This kid is clearly a menace to himself let’s put him in a safe place for 14 days that will fix him!” Has not and never will fix the problem. I am proof of that and I am sure countless others are too. Doing that made me resistant to seeking help in the future. It made me afraid of hospitals. It made me fear Partial Hospital Programs and Intensive Outpatient Programs.
I made the hardest decision of my life to surrender to the hospital. I asked my mother to drive me to Melrose-Wakefield. It is the only hospital in the vicinity that has any sort of psychiatric unit. The only other place I had been was Lahey Clinic and they mishandled the case due to lack of facilities. They just don’t have a unit. At all! They have plenty of liquid Ativan and they will hide you in the cardiac unit for a week until they can get a psychiatrist to come down from their floating psyche dept (not unit) to evaluate me. But hey! That’s a whole different story for another time. I chose Melrose-Wakefield Med 6.
Hopelessness is around me
All ye abandon hope at those elevator shaft doors who enter. A sense of dread now filled my gut. My intestines curled in response. It might just be the weeks of alcohol wearing off and the inevitable fits of anxiety setting in, but no, something else is bothering me. People were screaming and the environment is just as chaotic as the emergency room. The so-called common area was just a converted break room. I would bet my life on it that the poor staff may have given up that break room at some point so that the patients could have a common room to gather in. That’s how utterly repulsive the environment was. I surrendered my belongings to my mother. Anything that could injure me. I was left with nothing but some clothing. Some places allow phones to keep people socially engaged during the copious amounts of downtime. Not this place. They were too worried about pictures being taken.
Drowsy, frightened, and feeling helpless I was ready to just comply with any order to get this over with. They ordered my blood pressure. It was about 140/90. They were not pleased with that. I requested propranolol. They obliged my request and told me if it didn’t work they would send me to the hospital below. For a moment that sounded like an out, but I realized they would tie me to the bed and guard me. Twenty minutes later the meds kicked in and they were satisfied with the new number. I was allowed to pass through to the next phase.
They showed me to my room which was down a long hallway past a screaming woman who was very displeased with her stay at Med 6. She was in a manic state. At the time I didn’t understand this. I was quite frightened of her. I wanted her to stop screaming so I could sleep. I hadn’t even met my roommate, who clearly didn’t care that this lady was running up and down the halls with very strong opinions on the government.
They treat us like xmen
At this point, security is involved and I am safely listening from my bed. I know what’s happening though. I feel bad for her. Not just because she is a good person, but because nobody deserves to be treated like this. There are better ways. You can hear her cries as two or three large men wrestle her in the hallway. She is 5 foot tall even, maybe add an inch for good luck. It sounds like a bar fight with 10 brawlers. Eventually, they inject her which subdues her within minutes. The screaming turns to yell which fades to mumbling and then nothing but the guards handling her body and bringing her to the room next to mine. The “solitary” room. I can hear them as they hoist her into the doctor-visit-like chair. Except there are appendages for your arms and legs. Ladies, you may be more familiar with tables of this ilk. Just in case you’ve never seen a full body strap down chair before. They keep your appendages far apart so you can’t gain any leverage. They treat you like you have some sort of superpower. The straps go across the chest. Am I juggernaut? If you piss me off or trigger me. You sure did to that poor girl. Instead of helping her through her episode you tackled her and shot her up with Haldol and strapped her to a full body restraint chair. It took three of you. There is some deep rooted pain there to summon that kind of hatred and you respond with violence. All the while I am trying to sleep day one coming off weeks of alcohol abuse. I fight to find silence in my own thoughts…
surviving the night
The night is regularly interrupted by 15-minute checks as expected. Sleep is always light. The short duration between checks wears on you quick. Being woken up every 15 minutes cannot be good for your mental health. Seriously. Fight me on that. I will actually fight you. That is the mental state it puts you in. You can’t establish REM sleep. Your brain cannot properly refresh itself, with a flashlight in your face every 15 minutes. Use cameras, infrared lighting, more windows, I don’t care! Let patients sleep. Sleep is paramount to mental health.
The night was stormy and I used that to my advantage. The sound of the storm was mildly comforting over the violent environment. I focused on that above other things, with my blanket tightly wrapped around me like a sleeping bag. The blanket was thin and made of itchy fiber material. It was hard to call it comfortable, but I did not think to bring my own bedding day one. Waking up in the two-person room was a bit disorienting, mainly because I hadn’t even met my roommate. He was an older man in his 40s. Homeless, an alcoholic with no real support network. This was his rock bottom. He was being held here on court order until a halfway house could open up for him that would help him transition into the world again.
After the alcohol
I could relate to alcohol. It’s been over 24 hours since I have had any alcohol and I was heavily ingesting 80 proof vodka out of the bottle like it was water for weeks. My body was beginning to react to that. I stood up and shuffled over to the med line. I hadn’t taken any psychiatric medication in years. I knew what medications I was supposed to be taking, but hell if I was going to poison my body with those things. I clearly had a handle on myself. Clearly. This was a tradeoff. I needed anti-withdrawal medication. The only way they would give it to me was in a cocktail of psych meds. What choice did I have? I downed the little cup and swigged the tiny plastic water cup before mercilessly crushing it in my hand.
Two days of sleep and Librium before I could walk amongst the living. I am now clear from the alcohol and left in the haze of my own illness and medications. The utter drenching of my neurons in alcohol has left me with depression via serotonin. It will be weeks before the medications kick in if I even follow through with them. So what was I left with? Nothing of course. No comforts. No music. No phone. Nothing. Of course, it is a weekend which means there are no activities planned until Monday. I am left with a rack of old books that a prisoner at the local jail would be envious of but that’s about it. We are not allowed out for fresh air. The windows don’t open at all for our safety as we are six flights up in the air. If you want to call a loved one it COSTS money. You need actual quarters. Is this the reason they took my cellphone? I would have paid daily to just have kept my cell phone. I don’t even want to hear privacy complaint arguments because McLean’s Hospital allows the use of cell phones so kick rocks. It can be done. So many concessions COULD be made if the company in charge of the care of the patient actually cared about them. Instead, get treated like prisoners and given minimal human care. All during we are begging for the most brutally vulnerable thing you can ask for, sanctuary.
Hard pills to swallow
Stasticastally speaking, most people who cycle through acute psychiatric treatment clinics fail to adhere to their recommended medication regimen. I know I was one of those statistics. I can see why that was, given the utter chaotic and emergency room-like nature that was my care. Sterilized linoleum floors, plastic preschool indestructible chairs, ad-hoc lunch tables set up for activities in what was clearly once a mini breakroom egress in the nurses’ station. You cannot heal in the bleakness of such a miserable situation. Healing comes from beauty. All this for a huddling, crying mess surrendering himself for help. Would I ever do this again? No. I would sooner die and I don’t say that dramatically nor do I say that fishing for help. I am not looking to die either. I am looking to change this garbage system that would make someone come to such a conclusion rather than walk into a hospital for help. A safe place. A place that is supposed to have open arms. No exceptions. And I put my life into the hands of these people to be treated like a criminal.
A criminal simply trapped in holding. I had a good selection of books. I did not come here to read, but the bare minimum problem society set out to solve was achieved; I couldn’t hurt myself. Despite how absolutely miserable I was, technically I was safe. I had to reflect on that if I was going to at least get through the weekend. The goal was safety now more so than healing.
The Bureaucracy of care
There was a morning check-in outside the nurses’ station that faces the dayroom for souls bored out of their minds. The nurse chimes in with the morning announcements in a loud, unthreatening tone of voice. They consist of what activities are available for the day and how to sign up for them. They briefly explain how to sign up for other services as well and point to where vital stations are located like medication and reception.
Being a weekend, there isn’t much going on. All major groups are carried out during the week. That makes sense on paper, but if you think about it for a second it falls apart. Mental illness doesn’t take days off. My stay in that hospital may have only been that weekend due to insurance issues, and thanks to the policy, I would have received little to no care.
We clearly can’t just ask our mental health staff to put in overtime to cover these additional shifts either. I understand that. There is a greater problem here. A paradigm shift is required in the mental health system if we are going to fix this system and unburden the medical professionals who fight for people like me. I would propose drastic changes to the way we care for our mentally ill people, but that article is for another time. Bipolar is a disease of creativity, but it also sparks chaos. I struggle to stay on one story.
escape from med 6
Allow me to return from my digression. From the information I gleaned in the speech, I was to grab a menu from the desk and write my name and patient number down on it and select what I wanted for breakfast, lunch, and dinner. Since I arrived at night breakfast was selected for me. It was oatmeal and toast with jam and OJ. For lunch, I requested a grilled cheese with cole slaw and tomato soup, and dinner, a veggie burger and steak fries. The food was your average cafeteria grade food. Nothing special. I’m sure it cost $400 a plate.
My next mission was to find a pen and paper and begin writing a letter to the staff explaining why they needed to discharge me immediately on grounds of [redacted]. I spent a good three or four hours writing that letter before I found an envelope and sealed it up. I walked around the halls, read the names off of the fancy placards, I even asked the front desk for the name of my case manager. Then I had sufficient information to write a letter to the people I thought mattered.
I put the letter in the designated box and went on with my business. That is all I could do. The review wouldn’t be heard until Monday. That just starts the process too. Then I have to wait and hope they agree with what I said. I can’t worry about that right now though. It’s the weekend and I am here, alone with nothing to do but stare at some books. So I did. I read about 400 pages of a good book funnily enough called Hellhole.
The Victimless convict
Sunday brings little change to the environment, except that I am a bit more clear headed. Instead of reading, I decided I will put myself in the middle of the day room and draw. I figured this would make me a target for some more extraverted personalities to interact with me since this place is boring as cardboard. I began drawing tribal symbols. It is a calming technique I developed back in grade school when little tools were available to me. Eventually, a larger man came over and sat down next to me. For privacy, we will call him Eric.
Eric was here awaiting sentencing on a drug possession offense. A victimless crime. They had no place left for Eric at the county holding facility so they had to keep him here at the mental facility. This alarmed various people. He found that quite amusing. He was trying to get a rise out of me, but this crime being victimless I was not impressed and honestly felt bad he was there. I asked Eric if he preferred being here over a county holding facility. His eyes went blank and he looked away from me. I don’t think he had processed the thought before. We talked about our lives for quite a bit longer after that. I found out he cut hair. He offered me a shave before I left. My hair was down to my shoulders at this point and quite raggy.
Lunch arrived and trays were handed out. Names are shouted out by orderlies and patients rush across the floor to grab trays and find their spot. The system is barbaric, chaotic, and demeaning. PRO TIP: In an environment that is meant to reduce stress and anxiety drill Seargent meal calls are not a good system. I acquired my meal and returned to Eric. I noticed his meal was rather bland. He frowned and informed me that he was diabetic. The idea seemed to make him quite upset. I was having another veggie burger and fries. Eric had finished his meal before I had got halfway through mine and was off to try and eat other peoples discarded food.
Someone once told me I was born for aa because my initials were aa; f*ck them.
After lunch, I do remember attending an AA meeting but the experience was extremely triggering for me so most of it is blocked out. I don’t know if anyone else has that issue; AA itself just triggers my anxiety response. Sometimes it sends me into a full blown panic attack, the way certain people speak. Other speaking conventions don’t do that. I just find recanting past tales of trauma, well, traumatic and triggering!
After the AA meeting, my nerves were on fire from anxiety. Electricity was sparking across my chest cavity down my arms and into my waist. I was fighting just to breathe. I tell the nurses’ station I am taking a shower. This is actually anxiety in of itself for me. I know the running water will soothe me, but I am terrified of the sound of rushing water out of pipes. Bubbling soothing brook? Sure, love it! Blasting or hissing sound of water being forced out of pipes or nozzles or hoses? Terrified. Why? Neurotic. Another story – another time. So I headed down to the only shower available to me. It reminded me of a standing locker room shower. It had barely even felt clinical. Again, it borderline feels like a prison with its dank grimy grout tile. I am here to feel like I am worth something again － I cannot wash away my worthlessness in here when the shower itself feels worthless.
Wrapping it up before it begins
Wet and still feeling anxious from the shower I headed back to my room to fully dry off and change. I walked by my roommate reading his bible in the light of his bed lamp. After drying off it was time to head down to the day room for the evening check in before free time. People slowly shuffled from all corners of the floor to the day room for a nightly call. The purpose of this was mainly a head count. You have to make sure people are physically present as well as mentally. One by one the orderly calls off the patient names and asks them how their day was. We were to come up with something that we found positive from the day. As you can imagine this was a monumental task for many of us.
My turn came around and I spoke to my boredom and said I enjoyed a good book. The book had been good. It had dragged me through the torturous void that was the weekend. Now, I had to contend with actual licensed social workers and doctors as the week had begun. My letter of withdrawal against medical advice was already in the system before anyone even had a chance to evaluate me because the shock value of the system was so extreme. This is coming from someone who has had many involuntary hospitalizations and suicide watches. I look back with healing memories from those facilities. Not here.
Dawn of a new day
Monday begins, breakfast is served and I am with Eric and a couple of other patients that aren’t associating with anyone. Eric looks longingly at my pancake syrup. I’m not versed in biology, but maple syrup cannot be a good thing to give a diabetic. Eric asks me for it nonetheless and I cannot say no. He was given a simple, plain white toast slice to eat. Now he has plain white toast dipped in maple syrup. Oh well. Let the universe figure it out.
As my breakfast is being invaded morning announcements are beginning. There are groups today as I predicted. I read the sheet of paper on the wall after all. The first group on the list that piqued my interest was an anger management group. They also held a group on low mobility yoga that included chair yoga. Back then, due to the mass alcohol consumption, I was really bloated so chair yoga turned out to be a great way to relieve stress and inflammation. That is actually what got me started on my journey into yoga funny enough.
I didn’t meet with the doctors on Monday. The groups I managed to attend were passable. The clinical staff was good. They were thoughtful and it was clear they wanted to listen to your story. By the afternoon I had run out of groups to attend and I wasn’t going back to the book rack. I tracked down Eric and took him up on his offer for that haircut.
Face of a new me
Eric was taken by surprise. “Really! All of it?” He said. I wanted to get rid of all of my hair. It was tangled and breaking from neglect. I was doing my head a favor in the long run. We traveled down to the nurses’ station and requested the buzzers be taken out of the locker. The orderly on duty obliged and headed down to the lockers. After digging through some luggage, the orderly acquiesced a worn barber set to Eric. It would do.
With the soothing sound of the humming tiny motors, my hair began to fall from my scalp. This would be the first time I would have short hair since I was forced to shave it off for a cult; Another story. Wow. Who am I? I don’t know. I don’t think I ever knew.
Zip. Zip. Zip.
The buzzer rhythmically passes by my ears as my temples are revealed to the light of day. When I discarded all the hair, people were shocked. They thought I was an old man. When they realized I was a 26-year-old man all of a sudden they wanted to talk to me. Funny how only a man awaiting conviction for a victimless crime would recognize me. There may be a social experiment in there.
I began sweeping up my hair and returning the table and chairs to where the ad-hoc barber center was created. I thanked Eric and promised him some money when I left.
Do i detect change?
At the end of the day wrap up I had some different words this time. The main attraction was my hair. The orderly didn’t recognize me at first. My photo didn’t match my intake photo very well due to the lack of cave-man hair. I used chair yoga as an example of the one positive thing I had found for that day when asked. Once roll call was over and done with I doodled in the main day room (now a night room) until meds were called.
Tuesday brought more of the same. A morning wake-up for breakfast and a medication line littered with cranky nicotine addicts who can’t get their fix taken care of properly because there are no outdoor breaks – ever. I don’t blame them for being angry or wanting more gum or patches than they are allotted either. Let the damn people out on scheduled smoke breaks like human beings with habits.
Half the truth the so help me god
I participated in a morning group, the details at this point in my memory are fuzzy. I was pulled about three quarters through to meet with a counselor who wanted to speak to me about my note. I obliged as that was as close to my plan as I was going to get for now. I explained that my initial reasons for check-in were due to rapid alcohol consumption which posed an immediate threat to my life – true but not the whole truth. I argued that now that the alcohol had been removed, medications reintroduced, there was no more immediate danger. Again, more half-truths.
The counselor looked at me, my file, what I had been doing all weekend, and how I was presenting in their office at the time present. I could tell they were eyeing me up with those therapist’s eyes. That diagnostic glare. I’ve been building anti-therapist techniques since I was a teenager though. I can tell them what they need to hear. I have studied their manuals extensively because they gave them to me to study. That is the double-edged sword of psychiatric treatment.
back to anxiety
I am returned to the general population of the day room just in time to find my lunch tray being hovered over by Eric. Saving it for me, of course. I give him my dessert or something to that effect. My anxiety is so high in this place I cannot eat much anyways. I end up losing about 10lbs in 4 or 5 days. Also, keep in mind, due to heavy drinking I was holding a lot of water weight so the weight loss was not from lack of food.
The remainder of my day is just more of the same. There are new intakes that arrive sparsely as the unit is mostly full. When someone does leave it is often treated as an event, but not everyone wants that. I myself am one of the sneaks out the back like nobody knew you were there type.
I wait for the day to end so I can get evening meds. I am in a game of waiting. I am forced to spend my time reading a book I don’t care about to get to the end of the day. It could be worse. Nobody is screaming right now, so that is positive. Just keep pushing for med time.
Fleeing from fear
Tomorrow finally comes. I am pulled into the counselor meeting I’ve been waiting for. They told me my letter has been accepted. They don’t think I am a danger to myself anymore. They are happy to see me released on the condition I sign a follow-up plan and continue my medication treatment. I am offered an Intensive Outpatient Program with their sister hospital which I accept. It was there that I met my therapist for the next five years. Med 6 felt more like a place for mentally ill people awaiting trial or post-conviction. But that is not a standard we should rest ourselves at.
I walked out of those doors and down the keyed elevator with my belongings in my patient bag, ending my last time in an inpatient facility to date… I don’t say this triumphantly or to brag. I say it to make a point. One voluntary run was enough to consider my life not worth saving over ever subjecting me willingly to that again. What should have been a resource of respite in my journey to recovery from trauma and chemical imbalance endures to this day as a phantom. It reminds me that if I am not what society wants me to be, they have a special place waiting for me and it is a bin.
This story is based on true events and is recounted from memory. Names and dates are changed unless otherwise specified.
If you or someone you love is struggling with mental health issues here is a directory of resources: https://mentalillnessmouse.wordpress.com/helpfulresources/
Special Thanks to: Greg for editing this.
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