Whenever the rainbow appears in the clouds, I will see it and remember the everlasting covenant between God and all living creatures of every kind on the earth." Genesis 9:13

Locked Up: My Psychiatric Hospitalization (Hospitalization #1)

I started the 600 mg dose of Seroquel Sunday night and finally slept soundly. It was the first time I slept until they woke me for meds. I did, however, sleep very restlessly, with pillows thrown and blankets kicked off.

I was happy for Monday simply because it was the day with art therapy twice. Art therapy helped me so much. Enough
 I'm still doing art projects at home. But then I was sad because the morning one was cancelled.

I had extreme anxiety again that day and needed my PRN earlier than usual. I think a lot of that had to do with discharge and wanting to know what was happening, some was because I hated that others were leaving and I wasn't well enough, and part was the beginning of hypomania. I don't think it helped at all that between the anxiety meds and the higher dose of Seroquel I was very, very sleepy. I also was scared about asking to stay until Wed., even though I knew it was psychologically better.

When I saw the dr. he was fine with the Wednesday discharge. He did make sure to remind me I couldn't become too dependent on the safe environment, but I pointed out that I had never been a suicide risk like the last week had been and that I know pretty well how to judge my own safety because I've been doing it a long time, and only a few days after wanting to hurt myself was not a great deal of time. He was fine with that.

I spent time that day reflecting on the week and how different it had been from what I'd thought. It was (and still is) so odd to think that I drove up there on a beautiful fall morning, felling tired and sad and wanting to die, 15 minutes after arrival the door locked behind me, and I proceeded to totally fall apart and then start to recover. In 7 days. I also thought about how wrong my expectations had been. When I discussed this with Dr. Brain we didn't get too specific. Partly this was because she didn't know precisely what would happen since I didn't do this the way the manufacturer suggets. Partly we were supposed to have one more appointment before I went into the hospital. But I had thought that I would go in, start Emsam day 2, have everything else stay the same med-wise, and walk out in a week feeling much better. That wasn't quite the story. I had no idea how scary and horrible it would be to come off the med completely.

I also felt impatient that day. I'm used to pills that you take 4 days and can increase the dose, or whatever rate. Because of my sensitivies I generally am started on the lowest possible dose of things and raised gradually, as fast as allows my blood to stabilize. With the patch that can't be done. You have to wait it out for what seems like forever. I did increase after 2 weeks, but the hospital doctors wouldn't have allowed that.

I spent time on the phone that day making arrangements for things like Dr. Mind appointments (lots) and a Dr. Body appointment. I made a list of things that needed to be picked up on the way home. I also continued to feel very pressured and manicky, and realized eventually that I was hypomanic. I started wanting nothing but to go home. Oddly, along with my hypomania I was exhausted and had to fight to stay awake for the last group.

I was on a regular diet that day, but still they kept vegetables from me and once sent me creamer but no coffee or milk. I decided at that point that dietary hated me.

I wrote on and on about things I was tired of. I won't bore you. I was very upset that evening, and it was the first time it hit me that I really should have been talking to SOMEONE for therapy 1:1 while I was there, and that I was really upset this didn't happen. I almost sound panicky in my need to talk about it.

The final straw in my decision to discuss leaving on Tuesday after all was a new guy. Again, I don't want to say much about other patients. But he came in with this attitude that it was stupid and not what he wanted (yet it was a voluntary unit) and made lots of comments about HE had things in his life that were important and that HE didn't let things mess up his life and HE was functioning fine, just hadn't been compliant with his meds (which I don't think he saw as a problem). I hope he didn't realize how terribly insulting he was being, because he clearly saw the rest of us as a group that he viewed negatively and judged. I already knew I was hypomanic. Listening to him made me realize that I needed away from people and that I was losing all patience rapidly. I was so angry at him...

And that was the last full day. 

Thursday, November 26, 2009

Locked up, Day Nine. The Season Finale

I hope it's the series finale, but I know well enough now what it feels like to be off antidepressants and there is no changing from this to another without 2 weeks totally off, so it's not the end. While I would love Emsam to work for me forever, that's just not realistic and believing the last AD would made this time harder.

So anyway, when I woke up that morning I knew that I was firmly hypomanic (at the end I'll say I was mixed. I was mixed as that just means depressed and manic simultaneously; however I was calling it hypomanic because that was the horrible part, just as the week before the mixed had been called depression. I'm rarely having an episode that isn't mixed, so mixed isn't a very good descriptor for me). I had suspected it the night before, but now it was without a doubt. I can tell from my handwriting now that I was hypomanic; it changes drastically.

I wanted to leave. Immediately. I was so very overstimulated I couldn't tolerate it, and I knew that it would be worse to stay another day and than it would be to wait at home to see Dr. Mind. I needed quiet, I needed to get away from the lights, I needed space.

I talked to the social worker very early that day because I had wanted to know when I would be seeing Dr. Brain so I could be sure I hadn't scheduled something else that day, as I'd scheduled a bunch of therapy and a Dr. Body appointment over the next days, and a Dr. Brain appointment is pretty much an all day commitment. She was irritated at me for asking and for setting up those appointments. Which is idiotic, I knew I needed to be seeing Dr. Mind twice a week and I know (and she doesn't) that he doesn't work full-time and that his appointments can fill quickly and that I needed to schedule ahead or I wouldn't see him as much as I needed to.

So that's when they decided it was time to tell me Dr. Brain was off for a month. They thought. She'd make sure, but she thought it was some medical leave. I'd be set up with someone else. I was rather horrified at the  whole thought of that, but said nothing. I just hoped to be set up with Dr. Inpatient. I also wrote a resentful paragraph about how tired I was that every time I called Dr. Brain by her first name, which I've been doing for something like 7 years and which many of her patients do (and not only is this ok with her, but it's got to be remembered that I have an unusual relationship with her. I have seen her or spoken to her on the phone every month at least once, without missing one for 7 years, until this month. Plus we email a lot. It's just the nature of my illness and what I have needed. But every time I called her "Anne" I'd get a response about "DOCTOR BRAIN". Like I was wrong. It got really annoying, especially from the social worker who I was already mad at for telling me I was wrong to set up my own appointments with Dr. Mind.

I think the next paragraph of my journal says a lot:
"Want to cry. Really really really not tolerating this. It's worse to be mixed this way that to be like it was last week. Last week I was too depressed to feel the excess energy as painful, I didn't care about anything, and there was some counterbalancing. Today/yesterday I still am plenty depressed, but not so much that this doesn't have the blunting effect I had a week ago. So i'm in that lovely place where I want to move, move, move; I want to scream; I'm on the verge of tears for NO reason, and the need to leave her is almost panicky."
And that is how my hospital journal ends. I've got lots more I want to write about from that time, because I want to eventually make a blog section that is devoted to surviving hospitalization, plus I want a record of this for myself, and I want there to be a place online that tells the story of a longer psych stay, particularly one on a high functioning unit.
What happened next was the doctor came in, I explained that I NEEDED to go home despite what I'd said the day before, that I was so sorry that I was messing up scheduling but that staying would be torture, and I needed to be out of there. I can still hear how desperate I sounded. He said that was fine, that if a need had arisen I could even have left Monday and that they plan for such changes. From that point things went fast. The social worker came in and made a comment about how "oh, I guess you really ARE leaving now" and then told me that she'd call me the next day about seeing a psychiatrist. The research person came in and gave me a discharge assessment. The nurses gave me all of my things and some plastic bags for dirty clothes. A nursing student came and talked to me. I packed, and within an hour was buzzed out as if I'd never been locked in. (That was weird. It felt like they should at least CHECK that I was allowed to leave, or something).
And then the great Walgreens saga happened, and then I was finally home.

Friday, November 27, 2009

Locked Up, Addendum

I forgot the part that shows ones of the biggest reasons for frustration in the last part of the Locked Up series.

When I left the hospital I had the usual packet of prescriptions, discharge papers, lists of who I was to follow up with, etc. Dr. Brain's name was there but not an appointment. I was told the social worker would call me the next day with who I was to see when. Well, that day came and the end neared and I finally called her. First she scolded me for being impatient (it was 4:30 and I think I have a right to know how my own life is scheduled), and then she told me that Dr. Brain wanted me to wait until a certain date and then call and talk to a specific person who would get me in.

That's fine, although I'll be very glad when that day gets here next week.

But I still can't believe my last interaction with the place was not being contacted about something so important as a follow-up. Nor was I given someone to contact in an emergency, which was also dumb.

Anyway, enough of the bitterness.