The following is the story of my psychiatric hospitalization in November 2009. I had to go completely off antidepressant medication in order to change to an antidepressant of the MAOI class. These posts were written after my return home based on my notes and posts written for me by a friend and also by me as I recovered. It was a positive experience with some difficult parts, but the end result was a much healthier me so the main objective was achieved.
Locked up: Part One
Locked
up, Day Two
Locked Up: Day Three, Part One
As was the worst part of my week, month,and year.
Locked Up Day 3, Part Two
Sometime after lunch I was trying to read in my room when I heard another patient get a phone call. This happened all the time as the phones were outside my room. He was someone who'd come in after me, was not that sick, and really I think was admitted because he needed meds that worked established. So it's not like it was a bit surprise that he was getting better.
But all it took was hearing him say he felt a little better and I lost it, totally.
I started crying, which at first I didn't pay attention to because I'd been crying a lot. Not only was I dealing with severe depression I was going through a lot of biochemical changes from coming off the one med, and probably starting more from the new med.
But then I couldn't stop crying. The tech came past doing rounds, saw me crying and asked if I wanted to hear a joke. Lesson one if you want to work with psych patients: a joke is not going to distract someone who is crying so hard she can't breathe. I cried and cried, thinking he would get a nurse. After a while I realized he wasn't, so I wandered the halls sobbing looking for someone, even him, who could let them know I was in trouble. I couldn't find anyone. I think they were involved in another person's discharge and maybe on break. So I cried for another 30-45 minutes before I heard a nurse's voice. I knocked on the nursing station door and told her I couldn't stop crying.
At that point I'd had it, and I curled up in bed to sob. The nurse came in and told me I couldn't have more ativan so she'd paged the doctor for something else or an emergency dose. It took another 30 minutes before they had that med. I took it and then they let me sleep for a long time.
During those hours is when things were so scary that I'm dealing with trauma from them. I've felt suicidal before. It goes with the territory. I also have a lot of coping techniques developed over the years that have convinced me I was pretty safe. I was wrong. I never considered the impulsivity factor. If I had been able to hurt myself that day I would have. There is no question because I remember sobbing for quite a while over knowing I had nothing harmful anywhere near me. Learning that when I'm being treated as a suicide risk it is for an actual reason and not just to look good on paper was a terrible shock. Enough of a shock I apologized yesterday to Dr. Mind for fighting him so hard for so many years because what I thought I knew about this wasn't the whole story.
I went back to being on 15 minute checks. Not that they tell you, but it's fairly obvious when someone carries a notebook past you over and over making a notation.
After I woke up I had a headache from crying, so I took some tylenol. I then spent the rest of the evening dazed. I only talked if forced to. I was forced to particpate in the last group. I have no idea what it was or what I had to participate in, because I don't remember it and that's what my notes say, but I'm fairly sure that it was the nurse I hated, who printed off stuff from the internet and then read it to us (badly).
That night I started the increased Seroquel dose, and combined with everything else I think I slept a bit better. Which was the only good thing of that day.
I also learned that next time I'm in the hospital I want them to have an order for an injection of something, because I don't ever want to feel that worked up and then have to wait for more meds to come. I'd kind of assumed that was a typical thing, but it wasn't and not having that option led to quite a big more trauma.
I read this and there is just no way it is explaining the terror and panic of that day.
Locked up, Day 4
I didn't write much about this day. As I recall I was just so very anxious and nothing was helping. I started to realize that day that perhaps my ativan use for many years had resulted in tolerance.
I had an ok start to the day. I didn't feel like interacting with people and I felt like the anxiety was going to make my head explode, but I was getting used to that. The morning group, art therapy, which was the only one I liked, was cancelled. During that free time I emailed my boss to let her know that I didn't think I would be ready to return to work on the appointed date since I was going to be in the hospital longer than hoped for and I was really not doing well. I just wanted to know what the plan was, etc. About an hour later I checked my email and had something rather non-specific from her, and a 2nd email from HR about being sorry about my resignation, here were the details of my last paycheck, etc. Needless to say I panicked. Another patient got the nurse and after we talked a while and I had an ativan they brought me me cell phone to allow a private call. The doctor came in before that call was made and we talked about it too. We also increased my Seroquel yet again, to 500 mg. Finally I was able to call and it was a clerical error.
The "minor" error had me drugged enough to be pretty incapicitated most of the day and I had a very hard time coping. I had no interest in talking to the other patients. I know we had some sort of a therapy group that day but I don't think I participated much. There was also one of the very boring, let's read a worksheet groups about defense mechanisms or something.
After lunch the dietician came in and we had a horribly circular conversation about my not eating. I'd talk about how repulsive food was, she'd insist I try something that sounded awful. She refused to accept I wasn't eating because of the depression, that I had this problem long before I got to the hospital, and that I actually was trying my best to eat. She didn't get what I was saying.
By that evening I did at least participate in group without being forced. I think I volunteered a sentence even. I actually felt the smallest bit better, probably because I'd had more anxiety medication. I also had eaten some pudding, pretzels and a serving of cereal by the time I went to bed, which had to help.
I think that day 4 was when we were given the journals. I didn't actually write about things day to day for a few days after we got them. Mine starts with a list of close to 200 points I wanted to remember or think about. Eventually we'll get to those, at least the ones not covered already. I had a very hard time with the journals because they tell you up front that your room is searched daily and until I saw what a search involved I didn't want them to flip through and read about my thoughts on C., the nurse from hell. I may someday write a whole post on her, because she taught me a great deal about what I do not want to be as a healthcare provider.
That night I had a message that Dr. Brain had called when I was in group and said she'd try to email me. That email never came and I assume that is when whatever happened to her occurred. I still don't totally get why I couldn't be pulled from group for my doctor, but whatever. I just would have appreciated the reasurrance of her voice. But that just wasn't part of it I guesss.
And that's all I remember of that day.
Locked up, Day Five
Day five (actually the night of day four) was when I decided the anxiety was absolutely unbearable. I also was very afraid because while Vistaril had knocked me out when I was totally out of control, it only really worked if taken either when I had totally worn myself out with the anxiety or if I happened to catch it the second it started. Neither of which was particularly helpful. I also realized that I was showing signs of tolerance to Ativan, which I had been taking for years. So I talked to my psychiatrist, who was happy to change me to Klonopin and wrote for it to be given regularly, not PRN. I could (and did) still take Vistaril, but the first dose of Klonopin made a noticeable difference within a few hours.
Unfortunately that didn't last long. I've written before about the dietician who thought that if I was too depressed to eat the best thing to do was eat things that sounded worse than anything ever had sounded. Well, she was about to make my life a living hell.
That morning I had eaten a reasonable amount (an omelet) for the first time in weeks. I had picked something for lunch I thought I might try. My stated goal for the day was to eat one serving of something at every meal.
So when I got my lunch tray and not one thing I'd ordered was on it, I was pretty upset. With no warning or explanation I was sent a chicken breast on a bun, something I'd specifically told her I wasn't able to eat. I think I got some vegetables, although now what I asked for, plain mashed potatoes, and a bunch of kinds of juice. Because juice is filling. I was so upset, and asked the nurse. At first she didn't know why, then remembered they'd decided to put me on the MAOI diet. I said I understood that, but that the dose I was on didn't even require a diet, and the diet for Emsam isn't as strict as oral MAOIs, and that this is insane. I wasn't even allowed soup because the broth might be made from aged meat or something. I was horribly upset and all they would say is the doctor ok'd it and they'd look into it.
I was able to pick at my dinner enough to feel like I'd at least tried, but it too was not what I ordered at all.
Aside from being very upset about the food, that day was actually slightly better. I was given a tentative discharge date of Wednesday, maybe Thursday, and I spent some time talking to the other patients. I even wrote that I laughed twice. I started participating in groups a little more (ie I was saying things before I was forced to).
I also noted that day that I was becoming extremely frustrated that nobody was bothering to read my chart to know why I was there. Everyone knew I was bipolar; I was the only bipolar patient. But with 6 patients, 2 nurses, and a tech, along with support staff, I felt that by day 5 there shouldn't be ongoing questions about what signs I had missed that caused me to need to be hospitalized, what medication errors I had made, and what changes to my support system might help me. The first couple days I understood these questions, but by day five I was getting petulant. "what did you miss that led to your admission?" "My doctor told me to quit taking my pills and I did, and I was admitted when I realized I was about to miss the only way to keep myself alive". "Why did you stop your pills?" "Because the DOCTOR TOLD ME TO".
I know it's hard to know all about each patient. I also know that at any given time I'm responsible for 30 to 50 patients and I know at least the significant reason they are seeing me, usually much more than that. It's not like there were constantly different nurses; they kept staffing pretty consistent. So I felt there was no excuse. This also was enchanced by my anger at being called by my first name, which is not the one I use, no matter how often I correct people. Again, 6 patients, learn my name. They were doing this with half of us.
NAMI (National Association of the Mentally Ill) came that day. I was disappointed because it was scheduled during a relaxation training group I actually would have benefitted from. NAMI is a good organization, but it is very not local for me, and listening didn't help much. I also was very freaked out because we were given paperclips while they were there and I couldn't stop thinking about how I could hurt myself with said paperclip. I finally threw it into the heating register thing to get it away from me. I was too embarrassed to ask the nurse to take it, even though it would have been smarter. I did later admit to several people that I'd had trouble with this.
My biggest accomplishment that day was changing my previously scheduled appointment with my family doctor to a much sooner day (thank God I did that given that without him I'm pretty sure I'd be back in the the hospital right now). ---This is a total tangent, but I just realized finally why nobody wants to give me enough Klonopin to just take care of it. Duh. I totally forgot that not only am I on suicide precautions verbally for what feels like forever, the doctors aren't going to risk me having enough meds to hurt myself. Oh.---Anyway, I also left Dr. Mind a message cancelling an appointment I'd miss while in the hospital, asking for extra appointments to be set up for a while, and letting him know I was surviving. I really wish he had a private voicemail box, because I wanted to tell him how much it meant that the staff at the counseling center were praying, but I wasn't ready to announce that to the world. I still need to tell him that.
That was also the day I found out I was switching doctors. I'd not seen my "real" doctor until my 3rd day because he had flu. Then I saw him 3 days and he was out of town. So I saw this other doctor really more. It didn't matter, I liked both. The second must have wound up my dr of record since my online chart lets me set up an appointment with him. I thought I was going to have to, but now I think I can make it a few more weeks.
It started with a night of bad sleep. I had nightmares and kept waking up. I know I talked to the tech several times.
I started feeling dizzy from time to time from some minor blood pressure changes. This was expected and hasn't turned into anything major.
I ate my whole breakfast for the first time. I didn't get the sausage I'd ordered (totally legal on the MAOI diet), but I ate the rest. This turned out to be good since they substituted my whole lunch with a grilled cheese sandwich.
I talked to the doctor about the diet. I showed him the list I'd been given and then told him about my food card saying no broccoli, cauliflower, parsley, or spinach, none of which are on the main list. Then we talked about my not even really needed the diet and he said he'd modify it. He did ask me to watch soy intake, so no veggie burger, but otherwise I should be ok. He did write the orders, but nobody followed them all weekend because the dietician wouldn't change it but instead left a note in my chart that the doctor said made no sense, saying she wouldn't be responsible, etc. I asked to speak to her so she could explain the diet and a request was put through. She never did come back and now that I really do have dietary precautions I don't know entirely what they are. Nice, huh?
The doctor also increased my Seroquel dose to 600 mg per my request. He also said I probably could go home Tuesday, a day sooner than I'd last been told. I thought about it and realized I'd rather go home Wed. so that I could see Dr. Mind the next day. I wrote that down to ask the next time I saw him.
We had a group I was very disappointed with. Br. Brain had told me all about this one person who did weekend activities and everyone always had so much fun with her, etc. Well, she decided to do yet another "read aloud, lecture, and don't really discuss" group. This was on guilt. She bothered me also by bringing in a personal example from her life. This is normally fine, but this was something very sad and kept getting teary because I wasn't handling sad. It was the most boring 30 min. ever.
Then we were supposed to have a group on med compliance/management that I wasn't looking forward to, but nobody mentioned it. So from that point on it was an unscheduled day.
I spent 4 hours that day out of my room. I wore my sound blockers and made a collage. I was so tired of tan and green by that time that I made the most colorful collage I could come up wtih. It took a lot of focus since we couldn't have scissors without direct supervision, so the whole thing was torn and pasted. I also played cards with another patient for a while. It was good to do something different. Because I couldn't tolerate the noise I spent most of the time I wasn't in groups in my room, trying to read or doing very simple crossword and logic puzzles. Which was ok, but not enough options. By the end of the day though I knew I'd overdone it and I was really tired and anxious.
I also did laundry and changed my bed. I love clean sheets and clean pajamas.
The most disappointing thing was when we were paged for the last group. There was one nurse I'll write about eventually who I did not like, partly because of her condescending, long, boring groups she subjected us to when the group was designed per the other nurses to be just a time to talk about what happened during the day, something that was actually USEFUL. That group wasn't on the weekend schedule. When it was called I was as frustrated as I'd been since I was admitted. Thankfully the nurse who would be in charge the next night asked what kind of group we wanted so Sunday I got to look forward not having condescending group.
Saturday was the first time I was well enough to feel sad that I didn't have/allow visitors (event though it as the right decision), and I started to really miss my cats. They are so calming and I really needed that.
It also was the first day I was well enough to begin to see how horribly, frighteningly ill I had been. I think if I hadn't gone when I did Dr. Mind would have had to put me inpatient at my appointment I would have had the day I was admitted. 48 hours after I walked in there I was more out of control and dangerous to myself than I'd ever been before.
I also started thinking about how it is great that this works, but that an MAOI change to any other antidepressant would need a washout period and would put me back in the same place and that I need to talk to Dr. Brain about alternatives because I cannot ever go through another washout like that.
And that was day 6. Can you tell I was feeling better when I wrote about that day?
I was weighed and had lost 6 lbs since admission. I was somewhat surprised because since I wasn't eating I had been adding calories where I could, like using 2% milk, drinking pop, that kind of thing.
Locked Up, Day Seven
Day Seven started rudely. I fell asleep somewhere around 9:30 or 10:00 Saturday night. I was still holding a book and sitting up and the light was on, but all that medication really hit and I fell very sound asleep. It was unpleasant then when at midnight I was awakened and told that I couldn't have anything to eat or drink until blood was drawn in the morning. I have no idea why nobody would have told me that at say, 9:00 med pass. That night was the time change, and so instead of waking at my usual 5 (not that I start every day then, but I do start or completely wake up then), I was awake at 4, trying to force myself to sleep so I wouldn't think of how much I wanted water. Finally the nurse brought my thyroid med in and told me I could have water. I was pretty frustrated. First, drinking is really important with lithium and the kidney problem I have. Second, I'm thirsty ALL the time from meds. Third, it was the first time anyone told me what a test was or why it was done. I'm an adult, a competent adult, whether I'm on a psych unit or not, and I think the staff was disrespectful when they drew blood and did EKGs and on and on without telling us anything.
Eventually (and of course later than any other day blood was taken), the plebotomist (thankfully not the one who made a crazy joke on the psych unit) came and took my blood. Unfortunately she didn't put the pressure dressing on correctly and well, there was a messy incident.
I then went through a mess with meds that was ridiculous. I take a med called Nuvigil. It boosts my antidepressant and helps me wake up. It's a new version of an old med called Provigil. When I talked to admitting before I went to the hospital they said to bring med bottles so they could verify that things were written as I said. What they didn't tell me was that they'd also use my meds if they needed to. And with Nuvigil knowing that turned into a $450 loss on my part. What happened was that I only had about 5 when I went in. I didn't worry about calling Dr. Brain to be sure she'd gotten my insurance approval for me because I knew I'd see her within a few days of getting out and I'd be fine on those 5 until then. So I ran out, the hospital had none, and they seemed to have no clue what to do. Finally I gave them a script I had from Provigil that I still had in my purse and hours later I got a dose of that, which I think caused the hypomania we'll talk about tomorrow. (The reason this cost me $450 is that after discharge I had to get something and without prior authorization I had to pay. The hospital sent home a Provigil script which I also didn't have prior auth. for so I paid $136 for 10 pills, just so I had something. Some of the $450 I may be able to get back. A lot, probably not.)
Sunday was mostly a repeat of Saturday. Same awful group. I'm a Christian and I am a big advocate for Christian therapy and the role of faith in healing, but I was pretty upset about this group because she made it far too faith based. I felt that the psych unit, a place where people are so easily influenced, is not a place to talk about your specific beliefs. (Hers and mine weren't the same, but even if they were I wouldn't have thought it appropriate. Religious thoughts can be very distressing to some mentally ill people, and very confusing. Plus, that's a time you need to believe what you believe and be left to it.) Partly I feel like this because I know that I felt so confused and odd during some of that time that if someone had tried to teach me to follow the tenets of the Mayan faith (random example) I might have, despite that not being my belief system when well. I still have to talk to Dr. Mind about this part; we're approaching it but it's hard for me to say.
I again made a collage all afternoon, wearing my sound blockers. Being out was so exhausting. I wrote quite a bit that day about how I was so unsure I would be able to handle my noisy job in only 2 weeks.
I wound up napping that afternoon and a nurse had to wake me to eat. I shouldn't have bothered. Despite my doctor's attempts to help the diet, I was given 2 grilled cheese sandwiches that day, one for lunch and one for dinner. And I most certainly did not order two of them. I had been given a choice of broccoli, which is not on the MAOI diet but was listed as a thing I couldn't have on my card. I really wanted that broccoli. And they didn't give it to me. Nor did I get another food item. So I had an applesauce from the snacks, and spent another bit of my life very upset about this. Now that I'm home I'm still having a hard time figuring out what I can/want to eat. I still have a pretty limited number of things I'll eat, I just have figured out what I can eat that will supplement the calories a little on a day I'm not hungry, like today. I've also figured out some combinations that help, like egg beaters with a little breakfast sausage (can't have other sausage) and some safe cheese. I eat that a lot and it's got plenty of protein at least. Dr. Mind told me today that this symptom may hang on for a while. If it does I truly blame it on the hospital. I was ready for the diet. I was not ready to have a random set of restrictions even my doctor said I didn't need enforced. I was not ready to have every food that I might eat taken away from me immediately after being scolded for not eating. And I'm even more angry that I didn't get a dietary consult about the diet after requesting it, because now it's going to cost me $.
So dinner made me cry. Sunday was a harder day for me. A lot of people thought they might be going home Monday and I wasn't going to be going until Wed. or Thursday. I was a bit afraid of being alone, or being there alone with this one patient who....I don't want to say much about other patients......let's just say the high functioning unit was a stretch for her and if you want to know why I had a hard time look up "learned helplessness" and then consider she wouldn't sit near me at meals because with my special diet she couldn't copy my choices. Or the time I took a shower after her and had to spend 10 minutes cleaning up her dirty washclothes, dirty towels, the bottle of soap she'd spilled all over the clean linens, and her slowing spilling tipped shampoo bottle. That was not when I exactly felt like taking care of other people........
I was really surprised still at that point by how emotional I was. The crying about dinner (again) wasn't like me. The inability to accept that my diet was really screwed up and that what I was trying to fix that was ineffective was too much for me to accept. I also cried when I found a hair from my cat on my pants.
I worked more that day on being ready to leave. I called Walgreens and asked them to have patches available and was reassured they would. I asked the nurse for the tiny amount of guidance of what to do if a patch fell off. That answer was all the training I got in patch care and it's what I blame for my experimenting in treatments for broken out areas. (I know I'm obsessing about this, but the thing is that if an area breaks out I obviously can't patch it again until it heals. But what I learned last week is that I also need to avoid the area around that red area. And that gets tricky. On the other hand, I mixed up something that I think might actually be helping the hives even, and if it's better in the morning I'll mix up a good size batch and maybe that will help).
I had a lot of anxiety about when I was leaving. I'd been told anywhere from Tuesday to Friday. At that point Tuesday had been mentioned as hopeful. But I felt that it would be better to return to a support system, which meant either being scheduled for Dr. Brain the day after discharge, which wasn't ideal since it's a 2 hour drive each way, or going home Wed. to see Dr. Mind on Thursday. I was very worried about the fact that 2 days before I'd felt impulsive enough about hurting myself that I had to get rid of the one thing in my possession that might hurt me (paperclip).
This was also the first day my notes really complain about being there. I will discuss this a lot as time goes on (and may have some already), but I needed to be there. There is no doubt about that, and I got there just in time. They did what I was there for and I'm better and I was kept safe and mostly they were kind. It was certainly a better place for me than a general psych unit. However, for a unit set up for bipolar and depressed patients only, it wasn't all that appropriate for me. I was the only bipolar patient, and aside from my meds being different, nobody treated me differently. Nobody considered that my issues might differ a bit and if I tried to express that usually I was discounted. I also did not need to learn huge amounts about depression. For one thing, after as many years of therapy as I've had (ignoring my degrees and profession) I've been through this. For another depression is not the worst part of my illness and nobody ever talked about that part. This is where I am very bitter that I did not have anyone to talk to individually. I felt that a lot of it was very boring (partly it was because it was done in a way that did not help 6 severely depressed patients focus on the topic so nothing was ever connected nor was it enough sharing that we could help/learn from one another). I also felt a lot of groups were condescending, like "ok, this thing I downloaded from the internet says you all feel ______ and this is how you fix that". We might have been hospitalized but I think most of us could verbalize about how we felt about some topic all by ourselves. Generally I didn't feel anything like they said I should. Which was infuriating by the end. My final annoyance about groups was because the nurse I disliked, who was responsbile for the worst, internet based groups, felt that she could compare her frustration about having to go outside to smoke in the rain because of the law to our feelings about being trapped in various situations. You simply don't complain to a bunch of people who are locked up, missing the last week of fall weather and pretty leaves, about not enjoying your time outside. Thanks to the way the windows had heavy mesh on them, then blinds that nobody could control, we couldn't even see outside much of the time.
I had a long talk in the evening with another patient, the one I liked the most and who I was most upset about leaving on Monday. He was new to all this, so he had a lot of questions for me about my experiences, etc. He also told me how much better I looked that day, so much less haunted. That was such a good word for how I had looked. I literally was afraid to see myself for the first 4 days because the look in my eyes was bad. If Dr. Mind had seen me look that way he would have had me inpatient without hearing one word. I was so glad to find out that a lot of my frustrations weren't just me, including this nurse I really disliked (more on her eventually too).
That was a lot of writing. I think that shows how much better I felt; I could analyze the day and how I felt. Finally. I also was conversing by then, which was a big deal. I still don't feel like I can have any conversation I might want to because saying things isn't always easy. But that's just the thing where this takes more than 3 days.
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.
The following is the story of my psychiatric hospitalization in November 2009. I had to go completely off antidepressant medication in order to change to an antidepressant of the MAOI class. These posts were written after my return home based on my notes and posts written for me by a friend and also by me as I recovered. It was a positive experience with some difficult parts, but the end result was a much healthier me so the main objective was achieved.
Locked up: Part One
Locked
up, Day Two
Locked Up: Day Three, Part One
As was the worst part of my week, month,and year.
The following is the story of my psychiatric hospitalization in November 2009. I had to go completely off antidepressant medication in order to change to an antidepressant of the MAOI class. These posts were written after my return home based on my notes and posts written for me by a friend and also by me as I recovered. It was a positive experience with some difficult parts, but the end result was a much healthier me so the main objective was achieved.
Locked up: Part One
Locked up: Part One
Locked up, Day Two
Locked Up Day 3, Part Two
Sometime after lunch I was trying to read in my room when I heard another patient get a phone call. This happened all the time as the phones were outside my room. He was someone who'd come in after me, was not that sick, and really I think was admitted because he needed meds that worked established. So it's not like it was a bit surprise that he was getting better.
But all it took was hearing him say he felt a little better and I lost it, totally.
I started crying, which at first I didn't pay attention to because I'd been crying a lot. Not only was I dealing with severe depression I was going through a lot of biochemical changes from coming off the one med, and probably starting more from the new med.
But then I couldn't stop crying. The tech came past doing rounds, saw me crying and asked if I wanted to hear a joke. Lesson one if you want to work with psych patients: a joke is not going to distract someone who is crying so hard she can't breathe. I cried and cried, thinking he would get a nurse. After a while I realized he wasn't, so I wandered the halls sobbing looking for someone, even him, who could let them know I was in trouble. I couldn't find anyone. I think they were involved in another person's discharge and maybe on break. So I cried for another 30-45 minutes before I heard a nurse's voice. I knocked on the nursing station door and told her I couldn't stop crying.
At that point I'd had it, and I curled up in bed to sob. The nurse came in and told me I couldn't have more ativan so she'd paged the doctor for something else or an emergency dose. It took another 30 minutes before they had that med. I took it and then they let me sleep for a long time.
During those hours is when things were so scary that I'm dealing with trauma from them. I've felt suicidal before. It goes with the territory. I also have a lot of coping techniques developed over the years that have convinced me I was pretty safe. I was wrong. I never considered the impulsivity factor. If I had been able to hurt myself that day I would have. There is no question because I remember sobbing for quite a while over knowing I had nothing harmful anywhere near me. Learning that when I'm being treated as a suicide risk it is for an actual reason and not just to look good on paper was a terrible shock. Enough of a shock I apologized yesterday to Dr. Mind for fighting him so hard for so many years because what I thought I knew about this wasn't the whole story.
I went back to being on 15 minute checks. Not that they tell you, but it's fairly obvious when someone carries a notebook past you over and over making a notation.
After I woke up I had a headache from crying, so I took some tylenol. I then spent the rest of the evening dazed. I only talked if forced to. I was forced to particpate in the last group. I have no idea what it was or what I had to participate in, because I don't remember it and that's what my notes say, but I'm fairly sure that it was the nurse I hated, who printed off stuff from the internet and then read it to us (badly).
That night I started the increased Seroquel dose, and combined with everything else I think I slept a bit better. Which was the only good thing of that day.
I also learned that next time I'm in the hospital I want them to have an order for an injection of something, because I don't ever want to feel that worked up and then have to wait for more meds to come. I'd kind of assumed that was a typical thing, but it wasn't and not having that option led to quite a big more trauma.
I read this and there is just no way it is explaining the terror and panic of that day.
But all it took was hearing him say he felt a little better and I lost it, totally.
I started crying, which at first I didn't pay attention to because I'd been crying a lot. Not only was I dealing with severe depression I was going through a lot of biochemical changes from coming off the one med, and probably starting more from the new med.
But then I couldn't stop crying. The tech came past doing rounds, saw me crying and asked if I wanted to hear a joke. Lesson one if you want to work with psych patients: a joke is not going to distract someone who is crying so hard she can't breathe. I cried and cried, thinking he would get a nurse. After a while I realized he wasn't, so I wandered the halls sobbing looking for someone, even him, who could let them know I was in trouble. I couldn't find anyone. I think they were involved in another person's discharge and maybe on break. So I cried for another 30-45 minutes before I heard a nurse's voice. I knocked on the nursing station door and told her I couldn't stop crying.
At that point I'd had it, and I curled up in bed to sob. The nurse came in and told me I couldn't have more ativan so she'd paged the doctor for something else or an emergency dose. It took another 30 minutes before they had that med. I took it and then they let me sleep for a long time.
During those hours is when things were so scary that I'm dealing with trauma from them. I've felt suicidal before. It goes with the territory. I also have a lot of coping techniques developed over the years that have convinced me I was pretty safe. I was wrong. I never considered the impulsivity factor. If I had been able to hurt myself that day I would have. There is no question because I remember sobbing for quite a while over knowing I had nothing harmful anywhere near me. Learning that when I'm being treated as a suicide risk it is for an actual reason and not just to look good on paper was a terrible shock. Enough of a shock I apologized yesterday to Dr. Mind for fighting him so hard for so many years because what I thought I knew about this wasn't the whole story.
I went back to being on 15 minute checks. Not that they tell you, but it's fairly obvious when someone carries a notebook past you over and over making a notation.
After I woke up I had a headache from crying, so I took some tylenol. I then spent the rest of the evening dazed. I only talked if forced to. I was forced to particpate in the last group. I have no idea what it was or what I had to participate in, because I don't remember it and that's what my notes say, but I'm fairly sure that it was the nurse I hated, who printed off stuff from the internet and then read it to us (badly).
That night I started the increased Seroquel dose, and combined with everything else I think I slept a bit better. Which was the only good thing of that day.
I also learned that next time I'm in the hospital I want them to have an order for an injection of something, because I don't ever want to feel that worked up and then have to wait for more meds to come. I'd kind of assumed that was a typical thing, but it wasn't and not having that option led to quite a big more trauma.
I read this and there is just no way it is explaining the terror and panic of that day.
Locked up, Day 4
I didn't write much about this day. As I recall I was just so very anxious and nothing was helping. I started to realize that day that perhaps my ativan use for many years had resulted in tolerance.
I had an ok start to the day. I didn't feel like interacting with people and I felt like the anxiety was going to make my head explode, but I was getting used to that. The morning group, art therapy, which was the only one I liked, was cancelled. During that free time I emailed my boss to let her know that I didn't think I would be ready to return to work on the appointed date since I was going to be in the hospital longer than hoped for and I was really not doing well. I just wanted to know what the plan was, etc. About an hour later I checked my email and had something rather non-specific from her, and a 2nd email from HR about being sorry about my resignation, here were the details of my last paycheck, etc. Needless to say I panicked. Another patient got the nurse and after we talked a while and I had an ativan they brought me me cell phone to allow a private call. The doctor came in before that call was made and we talked about it too. We also increased my Seroquel yet again, to 500 mg. Finally I was able to call and it was a clerical error.
The "minor" error had me drugged enough to be pretty incapicitated most of the day and I had a very hard time coping. I had no interest in talking to the other patients. I know we had some sort of a therapy group that day but I don't think I participated much. There was also one of the very boring, let's read a worksheet groups about defense mechanisms or something.
After lunch the dietician came in and we had a horribly circular conversation about my not eating. I'd talk about how repulsive food was, she'd insist I try something that sounded awful. She refused to accept I wasn't eating because of the depression, that I had this problem long before I got to the hospital, and that I actually was trying my best to eat. She didn't get what I was saying.
By that evening I did at least participate in group without being forced. I think I volunteered a sentence even. I actually felt the smallest bit better, probably because I'd had more anxiety medication. I also had eaten some pudding, pretzels and a serving of cereal by the time I went to bed, which had to help.
I think that day 4 was when we were given the journals. I didn't actually write about things day to day for a few days after we got them. Mine starts with a list of close to 200 points I wanted to remember or think about. Eventually we'll get to those, at least the ones not covered already. I had a very hard time with the journals because they tell you up front that your room is searched daily and until I saw what a search involved I didn't want them to flip through and read about my thoughts on C., the nurse from hell. I may someday write a whole post on her, because she taught me a great deal about what I do not want to be as a healthcare provider.
That night I had a message that Dr. Brain had called when I was in group and said she'd try to email me. That email never came and I assume that is when whatever happened to her occurred. I still don't totally get why I couldn't be pulled from group for my doctor, but whatever. I just would have appreciated the reasurrance of her voice. But that just wasn't part of it I guesss.
And that's all I remember of that day.
I had an ok start to the day. I didn't feel like interacting with people and I felt like the anxiety was going to make my head explode, but I was getting used to that. The morning group, art therapy, which was the only one I liked, was cancelled. During that free time I emailed my boss to let her know that I didn't think I would be ready to return to work on the appointed date since I was going to be in the hospital longer than hoped for and I was really not doing well. I just wanted to know what the plan was, etc. About an hour later I checked my email and had something rather non-specific from her, and a 2nd email from HR about being sorry about my resignation, here were the details of my last paycheck, etc. Needless to say I panicked. Another patient got the nurse and after we talked a while and I had an ativan they brought me me cell phone to allow a private call. The doctor came in before that call was made and we talked about it too. We also increased my Seroquel yet again, to 500 mg. Finally I was able to call and it was a clerical error.
The "minor" error had me drugged enough to be pretty incapicitated most of the day and I had a very hard time coping. I had no interest in talking to the other patients. I know we had some sort of a therapy group that day but I don't think I participated much. There was also one of the very boring, let's read a worksheet groups about defense mechanisms or something.
After lunch the dietician came in and we had a horribly circular conversation about my not eating. I'd talk about how repulsive food was, she'd insist I try something that sounded awful. She refused to accept I wasn't eating because of the depression, that I had this problem long before I got to the hospital, and that I actually was trying my best to eat. She didn't get what I was saying.
By that evening I did at least participate in group without being forced. I think I volunteered a sentence even. I actually felt the smallest bit better, probably because I'd had more anxiety medication. I also had eaten some pudding, pretzels and a serving of cereal by the time I went to bed, which had to help.
I think that day 4 was when we were given the journals. I didn't actually write about things day to day for a few days after we got them. Mine starts with a list of close to 200 points I wanted to remember or think about. Eventually we'll get to those, at least the ones not covered already. I had a very hard time with the journals because they tell you up front that your room is searched daily and until I saw what a search involved I didn't want them to flip through and read about my thoughts on C., the nurse from hell. I may someday write a whole post on her, because she taught me a great deal about what I do not want to be as a healthcare provider.
That night I had a message that Dr. Brain had called when I was in group and said she'd try to email me. That email never came and I assume that is when whatever happened to her occurred. I still don't totally get why I couldn't be pulled from group for my doctor, but whatever. I just would have appreciated the reasurrance of her voice. But that just wasn't part of it I guesss.
And that's all I remember of that day.
Locked up, Day Five
Day five (actually the night of day four) was when I decided the anxiety was absolutely unbearable. I also was very afraid because while Vistaril had knocked me out when I was totally out of control, it only really worked if taken either when I had totally worn myself out with the anxiety or if I happened to catch it the second it started. Neither of which was particularly helpful. I also realized that I was showing signs of tolerance to Ativan, which I had been taking for years. So I talked to my psychiatrist, who was happy to change me to Klonopin and wrote for it to be given regularly, not PRN. I could (and did) still take Vistaril, but the first dose of Klonopin made a noticeable difference within a few hours.
Unfortunately that didn't last long. I've written before about the dietician who thought that if I was too depressed to eat the best thing to do was eat things that sounded worse than anything ever had sounded. Well, she was about to make my life a living hell.
That morning I had eaten a reasonable amount (an omelet) for the first time in weeks. I had picked something for lunch I thought I might try. My stated goal for the day was to eat one serving of something at every meal.
So when I got my lunch tray and not one thing I'd ordered was on it, I was pretty upset. With no warning or explanation I was sent a chicken breast on a bun, something I'd specifically told her I wasn't able to eat. I think I got some vegetables, although now what I asked for, plain mashed potatoes, and a bunch of kinds of juice. Because juice is filling. I was so upset, and asked the nurse. At first she didn't know why, then remembered they'd decided to put me on the MAOI diet. I said I understood that, but that the dose I was on didn't even require a diet, and the diet for Emsam isn't as strict as oral MAOIs, and that this is insane. I wasn't even allowed soup because the broth might be made from aged meat or something. I was horribly upset and all they would say is the doctor ok'd it and they'd look into it.
I was able to pick at my dinner enough to feel like I'd at least tried, but it too was not what I ordered at all.
Aside from being very upset about the food, that day was actually slightly better. I was given a tentative discharge date of Wednesday, maybe Thursday, and I spent some time talking to the other patients. I even wrote that I laughed twice. I started participating in groups a little more (ie I was saying things before I was forced to).
I also noted that day that I was becoming extremely frustrated that nobody was bothering to read my chart to know why I was there. Everyone knew I was bipolar; I was the only bipolar patient. But with 6 patients, 2 nurses, and a tech, along with support staff, I felt that by day 5 there shouldn't be ongoing questions about what signs I had missed that caused me to need to be hospitalized, what medication errors I had made, and what changes to my support system might help me. The first couple days I understood these questions, but by day five I was getting petulant. "what did you miss that led to your admission?" "My doctor told me to quit taking my pills and I did, and I was admitted when I realized I was about to miss the only way to keep myself alive". "Why did you stop your pills?" "Because the DOCTOR TOLD ME TO".
I know it's hard to know all about each patient. I also know that at any given time I'm responsible for 30 to 50 patients and I know at least the significant reason they are seeing me, usually much more than that. It's not like there were constantly different nurses; they kept staffing pretty consistent. So I felt there was no excuse. This also was enchanced by my anger at being called by my first name, which is not the one I use, no matter how often I correct people. Again, 6 patients, learn my name. They were doing this with half of us.
NAMI (National Association of the Mentally Ill) came that day. I was disappointed because it was scheduled during a relaxation training group I actually would have benefitted from. NAMI is a good organization, but it is very not local for me, and listening didn't help much. I also was very freaked out because we were given paperclips while they were there and I couldn't stop thinking about how I could hurt myself with said paperclip. I finally threw it into the heating register thing to get it away from me. I was too embarrassed to ask the nurse to take it, even though it would have been smarter. I did later admit to several people that I'd had trouble with this.
My biggest accomplishment that day was changing my previously scheduled appointment with my family doctor to a much sooner day (thank God I did that given that without him I'm pretty sure I'd be back in the the hospital right now). ---This is a total tangent, but I just realized finally why nobody wants to give me enough Klonopin to just take care of it. Duh. I totally forgot that not only am I on suicide precautions verbally for what feels like forever, the doctors aren't going to risk me having enough meds to hurt myself. Oh.---Anyway, I also left Dr. Mind a message cancelling an appointment I'd miss while in the hospital, asking for extra appointments to be set up for a while, and letting him know I was surviving. I really wish he had a private voicemail box, because I wanted to tell him how much it meant that the staff at the counseling center were praying, but I wasn't ready to announce that to the world. I still need to tell him that.
That was also the day I found out I was switching doctors. I'd not seen my "real" doctor until my 3rd day because he had flu. Then I saw him 3 days and he was out of town. So I saw this other doctor really more. It didn't matter, I liked both. The second must have wound up my dr of record since my online chart lets me set up an appointment with him. I thought I was going to have to, but now I think I can make it a few more weeks.
Unfortunately that didn't last long. I've written before about the dietician who thought that if I was too depressed to eat the best thing to do was eat things that sounded worse than anything ever had sounded. Well, she was about to make my life a living hell.
That morning I had eaten a reasonable amount (an omelet) for the first time in weeks. I had picked something for lunch I thought I might try. My stated goal for the day was to eat one serving of something at every meal.
So when I got my lunch tray and not one thing I'd ordered was on it, I was pretty upset. With no warning or explanation I was sent a chicken breast on a bun, something I'd specifically told her I wasn't able to eat. I think I got some vegetables, although now what I asked for, plain mashed potatoes, and a bunch of kinds of juice. Because juice is filling. I was so upset, and asked the nurse. At first she didn't know why, then remembered they'd decided to put me on the MAOI diet. I said I understood that, but that the dose I was on didn't even require a diet, and the diet for Emsam isn't as strict as oral MAOIs, and that this is insane. I wasn't even allowed soup because the broth might be made from aged meat or something. I was horribly upset and all they would say is the doctor ok'd it and they'd look into it.
I was able to pick at my dinner enough to feel like I'd at least tried, but it too was not what I ordered at all.
Aside from being very upset about the food, that day was actually slightly better. I was given a tentative discharge date of Wednesday, maybe Thursday, and I spent some time talking to the other patients. I even wrote that I laughed twice. I started participating in groups a little more (ie I was saying things before I was forced to).
I also noted that day that I was becoming extremely frustrated that nobody was bothering to read my chart to know why I was there. Everyone knew I was bipolar; I was the only bipolar patient. But with 6 patients, 2 nurses, and a tech, along with support staff, I felt that by day 5 there shouldn't be ongoing questions about what signs I had missed that caused me to need to be hospitalized, what medication errors I had made, and what changes to my support system might help me. The first couple days I understood these questions, but by day five I was getting petulant. "what did you miss that led to your admission?" "My doctor told me to quit taking my pills and I did, and I was admitted when I realized I was about to miss the only way to keep myself alive". "Why did you stop your pills?" "Because the DOCTOR TOLD ME TO".
I know it's hard to know all about each patient. I also know that at any given time I'm responsible for 30 to 50 patients and I know at least the significant reason they are seeing me, usually much more than that. It's not like there were constantly different nurses; they kept staffing pretty consistent. So I felt there was no excuse. This also was enchanced by my anger at being called by my first name, which is not the one I use, no matter how often I correct people. Again, 6 patients, learn my name. They were doing this with half of us.
NAMI (National Association of the Mentally Ill) came that day. I was disappointed because it was scheduled during a relaxation training group I actually would have benefitted from. NAMI is a good organization, but it is very not local for me, and listening didn't help much. I also was very freaked out because we were given paperclips while they were there and I couldn't stop thinking about how I could hurt myself with said paperclip. I finally threw it into the heating register thing to get it away from me. I was too embarrassed to ask the nurse to take it, even though it would have been smarter. I did later admit to several people that I'd had trouble with this.
My biggest accomplishment that day was changing my previously scheduled appointment with my family doctor to a much sooner day (thank God I did that given that without him I'm pretty sure I'd be back in the the hospital right now). ---This is a total tangent, but I just realized finally why nobody wants to give me enough Klonopin to just take care of it. Duh. I totally forgot that not only am I on suicide precautions verbally for what feels like forever, the doctors aren't going to risk me having enough meds to hurt myself. Oh.---Anyway, I also left Dr. Mind a message cancelling an appointment I'd miss while in the hospital, asking for extra appointments to be set up for a while, and letting him know I was surviving. I really wish he had a private voicemail box, because I wanted to tell him how much it meant that the staff at the counseling center were praying, but I wasn't ready to announce that to the world. I still need to tell him that.
That was also the day I found out I was switching doctors. I'd not seen my "real" doctor until my 3rd day because he had flu. Then I saw him 3 days and he was out of town. So I saw this other doctor really more. It didn't matter, I liked both. The second must have wound up my dr of record since my online chart lets me set up an appointment with him. I thought I was going to have to, but now I think I can make it a few more weeks.
It started with a night of bad sleep. I had nightmares and kept waking up. I know I talked to the tech several times.
I started feeling dizzy from time to time from some minor blood pressure changes. This was expected and hasn't turned into anything major.
I ate my whole breakfast for the first time. I didn't get the sausage I'd ordered (totally legal on the MAOI diet), but I ate the rest. This turned out to be good since they substituted my whole lunch with a grilled cheese sandwich.
I talked to the doctor about the diet. I showed him the list I'd been given and then told him about my food card saying no broccoli, cauliflower, parsley, or spinach, none of which are on the main list. Then we talked about my not even really needed the diet and he said he'd modify it. He did ask me to watch soy intake, so no veggie burger, but otherwise I should be ok. He did write the orders, but nobody followed them all weekend because the dietician wouldn't change it but instead left a note in my chart that the doctor said made no sense, saying she wouldn't be responsible, etc. I asked to speak to her so she could explain the diet and a request was put through. She never did come back and now that I really do have dietary precautions I don't know entirely what they are. Nice, huh?
The doctor also increased my Seroquel dose to 600 mg per my request. He also said I probably could go home Tuesday, a day sooner than I'd last been told. I thought about it and realized I'd rather go home Wed. so that I could see Dr. Mind the next day. I wrote that down to ask the next time I saw him.
We had a group I was very disappointed with. Br. Brain had told me all about this one person who did weekend activities and everyone always had so much fun with her, etc. Well, she decided to do yet another "read aloud, lecture, and don't really discuss" group. This was on guilt. She bothered me also by bringing in a personal example from her life. This is normally fine, but this was something very sad and kept getting teary because I wasn't handling sad. It was the most boring 30 min. ever.
Then we were supposed to have a group on med compliance/management that I wasn't looking forward to, but nobody mentioned it. So from that point on it was an unscheduled day.
I spent 4 hours that day out of my room. I wore my sound blockers and made a collage. I was so tired of tan and green by that time that I made the most colorful collage I could come up wtih. It took a lot of focus since we couldn't have scissors without direct supervision, so the whole thing was torn and pasted. I also played cards with another patient for a while. It was good to do something different. Because I couldn't tolerate the noise I spent most of the time I wasn't in groups in my room, trying to read or doing very simple crossword and logic puzzles. Which was ok, but not enough options. By the end of the day though I knew I'd overdone it and I was really tired and anxious.
I also did laundry and changed my bed. I love clean sheets and clean pajamas.
The most disappointing thing was when we were paged for the last group. There was one nurse I'll write about eventually who I did not like, partly because of her condescending, long, boring groups she subjected us to when the group was designed per the other nurses to be just a time to talk about what happened during the day, something that was actually USEFUL. That group wasn't on the weekend schedule. When it was called I was as frustrated as I'd been since I was admitted. Thankfully the nurse who would be in charge the next night asked what kind of group we wanted so Sunday I got to look forward not having condescending group.
Saturday was the first time I was well enough to feel sad that I didn't have/allow visitors (event though it as the right decision), and I started to really miss my cats. They are so calming and I really needed that.
It also was the first day I was well enough to begin to see how horribly, frighteningly ill I had been. I think if I hadn't gone when I did Dr. Mind would have had to put me inpatient at my appointment I would have had the day I was admitted. 48 hours after I walked in there I was more out of control and dangerous to myself than I'd ever been before.
I also started thinking about how it is great that this works, but that an MAOI change to any other antidepressant would need a washout period and would put me back in the same place and that I need to talk to Dr. Brain about alternatives because I cannot ever go through another washout like that.
And that was day 6. Can you tell I was feeling better when I wrote about that day?
I was weighed and had lost 6 lbs since admission. I was somewhat surprised because since I wasn't eating I had been adding calories where I could, like using 2% milk, drinking pop, that kind of thing.
Locked Up, Day Seven
Day Seven started rudely. I fell asleep somewhere around 9:30 or 10:00 Saturday night. I was still holding a book and sitting up and the light was on, but all that medication really hit and I fell very sound asleep. It was unpleasant then when at midnight I was awakened and told that I couldn't have anything to eat or drink until blood was drawn in the morning. I have no idea why nobody would have told me that at say, 9:00 med pass. That night was the time change, and so instead of waking at my usual 5 (not that I start every day then, but I do start or completely wake up then), I was awake at 4, trying to force myself to sleep so I wouldn't think of how much I wanted water. Finally the nurse brought my thyroid med in and told me I could have water. I was pretty frustrated. First, drinking is really important with lithium and the kidney problem I have. Second, I'm thirsty ALL the time from meds. Third, it was the first time anyone told me what a test was or why it was done. I'm an adult, a competent adult, whether I'm on a psych unit or not, and I think the staff was disrespectful when they drew blood and did EKGs and on and on without telling us anything.
Eventually (and of course later than any other day blood was taken), the plebotomist (thankfully not the one who made a crazy joke on the psych unit) came and took my blood. Unfortunately she didn't put the pressure dressing on correctly and well, there was a messy incident.
I then went through a mess with meds that was ridiculous. I take a med called Nuvigil. It boosts my antidepressant and helps me wake up. It's a new version of an old med called Provigil. When I talked to admitting before I went to the hospital they said to bring med bottles so they could verify that things were written as I said. What they didn't tell me was that they'd also use my meds if they needed to. And with Nuvigil knowing that turned into a $450 loss on my part. What happened was that I only had about 5 when I went in. I didn't worry about calling Dr. Brain to be sure she'd gotten my insurance approval for me because I knew I'd see her within a few days of getting out and I'd be fine on those 5 until then. So I ran out, the hospital had none, and they seemed to have no clue what to do. Finally I gave them a script I had from Provigil that I still had in my purse and hours later I got a dose of that, which I think caused the hypomania we'll talk about tomorrow. (The reason this cost me $450 is that after discharge I had to get something and without prior authorization I had to pay. The hospital sent home a Provigil script which I also didn't have prior auth. for so I paid $136 for 10 pills, just so I had something. Some of the $450 I may be able to get back. A lot, probably not.)
Sunday was mostly a repeat of Saturday. Same awful group. I'm a Christian and I am a big advocate for Christian therapy and the role of faith in healing, but I was pretty upset about this group because she made it far too faith based. I felt that the psych unit, a place where people are so easily influenced, is not a place to talk about your specific beliefs. (Hers and mine weren't the same, but even if they were I wouldn't have thought it appropriate. Religious thoughts can be very distressing to some mentally ill people, and very confusing. Plus, that's a time you need to believe what you believe and be left to it.) Partly I feel like this because I know that I felt so confused and odd during some of that time that if someone had tried to teach me to follow the tenets of the Mayan faith (random example) I might have, despite that not being my belief system when well. I still have to talk to Dr. Mind about this part; we're approaching it but it's hard for me to say.
I again made a collage all afternoon, wearing my sound blockers. Being out was so exhausting. I wrote quite a bit that day about how I was so unsure I would be able to handle my noisy job in only 2 weeks.
I wound up napping that afternoon and a nurse had to wake me to eat. I shouldn't have bothered. Despite my doctor's attempts to help the diet, I was given 2 grilled cheese sandwiches that day, one for lunch and one for dinner. And I most certainly did not order two of them. I had been given a choice of broccoli, which is not on the MAOI diet but was listed as a thing I couldn't have on my card. I really wanted that broccoli. And they didn't give it to me. Nor did I get another food item. So I had an applesauce from the snacks, and spent another bit of my life very upset about this. Now that I'm home I'm still having a hard time figuring out what I can/want to eat. I still have a pretty limited number of things I'll eat, I just have figured out what I can eat that will supplement the calories a little on a day I'm not hungry, like today. I've also figured out some combinations that help, like egg beaters with a little breakfast sausage (can't have other sausage) and some safe cheese. I eat that a lot and it's got plenty of protein at least. Dr. Mind told me today that this symptom may hang on for a while. If it does I truly blame it on the hospital. I was ready for the diet. I was not ready to have a random set of restrictions even my doctor said I didn't need enforced. I was not ready to have every food that I might eat taken away from me immediately after being scolded for not eating. And I'm even more angry that I didn't get a dietary consult about the diet after requesting it, because now it's going to cost me $.
So dinner made me cry. Sunday was a harder day for me. A lot of people thought they might be going home Monday and I wasn't going to be going until Wed. or Thursday. I was a bit afraid of being alone, or being there alone with this one patient who....I don't want to say much about other patients......let's just say the high functioning unit was a stretch for her and if you want to know why I had a hard time look up "learned helplessness" and then consider she wouldn't sit near me at meals because with my special diet she couldn't copy my choices. Or the time I took a shower after her and had to spend 10 minutes cleaning up her dirty washclothes, dirty towels, the bottle of soap she'd spilled all over the clean linens, and her slowing spilling tipped shampoo bottle. That was not when I exactly felt like taking care of other people........
I was really surprised still at that point by how emotional I was. The crying about dinner (again) wasn't like me. The inability to accept that my diet was really screwed up and that what I was trying to fix that was ineffective was too much for me to accept. I also cried when I found a hair from my cat on my pants.
I worked more that day on being ready to leave. I called Walgreens and asked them to have patches available and was reassured they would. I asked the nurse for the tiny amount of guidance of what to do if a patch fell off. That answer was all the training I got in patch care and it's what I blame for my experimenting in treatments for broken out areas. (I know I'm obsessing about this, but the thing is that if an area breaks out I obviously can't patch it again until it heals. But what I learned last week is that I also need to avoid the area around that red area. And that gets tricky. On the other hand, I mixed up something that I think might actually be helping the hives even, and if it's better in the morning I'll mix up a good size batch and maybe that will help).
I had a lot of anxiety about when I was leaving. I'd been told anywhere from Tuesday to Friday. At that point Tuesday had been mentioned as hopeful. But I felt that it would be better to return to a support system, which meant either being scheduled for Dr. Brain the day after discharge, which wasn't ideal since it's a 2 hour drive each way, or going home Wed. to see Dr. Mind on Thursday. I was very worried about the fact that 2 days before I'd felt impulsive enough about hurting myself that I had to get rid of the one thing in my possession that might hurt me (paperclip).
This was also the first day my notes really complain about being there. I will discuss this a lot as time goes on (and may have some already), but I needed to be there. There is no doubt about that, and I got there just in time. They did what I was there for and I'm better and I was kept safe and mostly they were kind. It was certainly a better place for me than a general psych unit. However, for a unit set up for bipolar and depressed patients only, it wasn't all that appropriate for me. I was the only bipolar patient, and aside from my meds being different, nobody treated me differently. Nobody considered that my issues might differ a bit and if I tried to express that usually I was discounted. I also did not need to learn huge amounts about depression. For one thing, after as many years of therapy as I've had (ignoring my degrees and profession) I've been through this. For another depression is not the worst part of my illness and nobody ever talked about that part. This is where I am very bitter that I did not have anyone to talk to individually. I felt that a lot of it was very boring (partly it was because it was done in a way that did not help 6 severely depressed patients focus on the topic so nothing was ever connected nor was it enough sharing that we could help/learn from one another). I also felt a lot of groups were condescending, like "ok, this thing I downloaded from the internet says you all feel ______ and this is how you fix that". We might have been hospitalized but I think most of us could verbalize about how we felt about some topic all by ourselves. Generally I didn't feel anything like they said I should. Which was infuriating by the end. My final annoyance about groups was because the nurse I disliked, who was responsbile for the worst, internet based groups, felt that she could compare her frustration about having to go outside to smoke in the rain because of the law to our feelings about being trapped in various situations. You simply don't complain to a bunch of people who are locked up, missing the last week of fall weather and pretty leaves, about not enjoying your time outside. Thanks to the way the windows had heavy mesh on them, then blinds that nobody could control, we couldn't even see outside much of the time.
I had a long talk in the evening with another patient, the one I liked the most and who I was most upset about leaving on Monday. He was new to all this, so he had a lot of questions for me about my experiences, etc. He also told me how much better I looked that day, so much less haunted. That was such a good word for how I had looked. I literally was afraid to see myself for the first 4 days because the look in my eyes was bad. If Dr. Mind had seen me look that way he would have had me inpatient without hearing one word. I was so glad to find out that a lot of my frustrations weren't just me, including this nurse I really disliked (more on her eventually too).
That was a lot of writing. I think that shows how much better I felt; I could analyze the day and how I felt. Finally. I also was conversing by then, which was a big deal. I still don't feel like I can have any conversation I might want to because saying things isn't always easy. But that's just the thing where this takes more than 3 days.
Eventually (and of course later than any other day blood was taken), the plebotomist (thankfully not the one who made a crazy joke on the psych unit) came and took my blood. Unfortunately she didn't put the pressure dressing on correctly and well, there was a messy incident.
I then went through a mess with meds that was ridiculous. I take a med called Nuvigil. It boosts my antidepressant and helps me wake up. It's a new version of an old med called Provigil. When I talked to admitting before I went to the hospital they said to bring med bottles so they could verify that things were written as I said. What they didn't tell me was that they'd also use my meds if they needed to. And with Nuvigil knowing that turned into a $450 loss on my part. What happened was that I only had about 5 when I went in. I didn't worry about calling Dr. Brain to be sure she'd gotten my insurance approval for me because I knew I'd see her within a few days of getting out and I'd be fine on those 5 until then. So I ran out, the hospital had none, and they seemed to have no clue what to do. Finally I gave them a script I had from Provigil that I still had in my purse and hours later I got a dose of that, which I think caused the hypomania we'll talk about tomorrow. (The reason this cost me $450 is that after discharge I had to get something and without prior authorization I had to pay. The hospital sent home a Provigil script which I also didn't have prior auth. for so I paid $136 for 10 pills, just so I had something. Some of the $450 I may be able to get back. A lot, probably not.)
Sunday was mostly a repeat of Saturday. Same awful group. I'm a Christian and I am a big advocate for Christian therapy and the role of faith in healing, but I was pretty upset about this group because she made it far too faith based. I felt that the psych unit, a place where people are so easily influenced, is not a place to talk about your specific beliefs. (Hers and mine weren't the same, but even if they were I wouldn't have thought it appropriate. Religious thoughts can be very distressing to some mentally ill people, and very confusing. Plus, that's a time you need to believe what you believe and be left to it.) Partly I feel like this because I know that I felt so confused and odd during some of that time that if someone had tried to teach me to follow the tenets of the Mayan faith (random example) I might have, despite that not being my belief system when well. I still have to talk to Dr. Mind about this part; we're approaching it but it's hard for me to say.
I again made a collage all afternoon, wearing my sound blockers. Being out was so exhausting. I wrote quite a bit that day about how I was so unsure I would be able to handle my noisy job in only 2 weeks.
I wound up napping that afternoon and a nurse had to wake me to eat. I shouldn't have bothered. Despite my doctor's attempts to help the diet, I was given 2 grilled cheese sandwiches that day, one for lunch and one for dinner. And I most certainly did not order two of them. I had been given a choice of broccoli, which is not on the MAOI diet but was listed as a thing I couldn't have on my card. I really wanted that broccoli. And they didn't give it to me. Nor did I get another food item. So I had an applesauce from the snacks, and spent another bit of my life very upset about this. Now that I'm home I'm still having a hard time figuring out what I can/want to eat. I still have a pretty limited number of things I'll eat, I just have figured out what I can eat that will supplement the calories a little on a day I'm not hungry, like today. I've also figured out some combinations that help, like egg beaters with a little breakfast sausage (can't have other sausage) and some safe cheese. I eat that a lot and it's got plenty of protein at least. Dr. Mind told me today that this symptom may hang on for a while. If it does I truly blame it on the hospital. I was ready for the diet. I was not ready to have a random set of restrictions even my doctor said I didn't need enforced. I was not ready to have every food that I might eat taken away from me immediately after being scolded for not eating. And I'm even more angry that I didn't get a dietary consult about the diet after requesting it, because now it's going to cost me $.
So dinner made me cry. Sunday was a harder day for me. A lot of people thought they might be going home Monday and I wasn't going to be going until Wed. or Thursday. I was a bit afraid of being alone, or being there alone with this one patient who....I don't want to say much about other patients......let's just say the high functioning unit was a stretch for her and if you want to know why I had a hard time look up "learned helplessness" and then consider she wouldn't sit near me at meals because with my special diet she couldn't copy my choices. Or the time I took a shower after her and had to spend 10 minutes cleaning up her dirty washclothes, dirty towels, the bottle of soap she'd spilled all over the clean linens, and her slowing spilling tipped shampoo bottle. That was not when I exactly felt like taking care of other people........
I was really surprised still at that point by how emotional I was. The crying about dinner (again) wasn't like me. The inability to accept that my diet was really screwed up and that what I was trying to fix that was ineffective was too much for me to accept. I also cried when I found a hair from my cat on my pants.
I worked more that day on being ready to leave. I called Walgreens and asked them to have patches available and was reassured they would. I asked the nurse for the tiny amount of guidance of what to do if a patch fell off. That answer was all the training I got in patch care and it's what I blame for my experimenting in treatments for broken out areas. (I know I'm obsessing about this, but the thing is that if an area breaks out I obviously can't patch it again until it heals. But what I learned last week is that I also need to avoid the area around that red area. And that gets tricky. On the other hand, I mixed up something that I think might actually be helping the hives even, and if it's better in the morning I'll mix up a good size batch and maybe that will help).
I had a lot of anxiety about when I was leaving. I'd been told anywhere from Tuesday to Friday. At that point Tuesday had been mentioned as hopeful. But I felt that it would be better to return to a support system, which meant either being scheduled for Dr. Brain the day after discharge, which wasn't ideal since it's a 2 hour drive each way, or going home Wed. to see Dr. Mind on Thursday. I was very worried about the fact that 2 days before I'd felt impulsive enough about hurting myself that I had to get rid of the one thing in my possession that might hurt me (paperclip).
This was also the first day my notes really complain about being there. I will discuss this a lot as time goes on (and may have some already), but I needed to be there. There is no doubt about that, and I got there just in time. They did what I was there for and I'm better and I was kept safe and mostly they were kind. It was certainly a better place for me than a general psych unit. However, for a unit set up for bipolar and depressed patients only, it wasn't all that appropriate for me. I was the only bipolar patient, and aside from my meds being different, nobody treated me differently. Nobody considered that my issues might differ a bit and if I tried to express that usually I was discounted. I also did not need to learn huge amounts about depression. For one thing, after as many years of therapy as I've had (ignoring my degrees and profession) I've been through this. For another depression is not the worst part of my illness and nobody ever talked about that part. This is where I am very bitter that I did not have anyone to talk to individually. I felt that a lot of it was very boring (partly it was because it was done in a way that did not help 6 severely depressed patients focus on the topic so nothing was ever connected nor was it enough sharing that we could help/learn from one another). I also felt a lot of groups were condescending, like "ok, this thing I downloaded from the internet says you all feel ______ and this is how you fix that". We might have been hospitalized but I think most of us could verbalize about how we felt about some topic all by ourselves. Generally I didn't feel anything like they said I should. Which was infuriating by the end. My final annoyance about groups was because the nurse I disliked, who was responsbile for the worst, internet based groups, felt that she could compare her frustration about having to go outside to smoke in the rain because of the law to our feelings about being trapped in various situations. You simply don't complain to a bunch of people who are locked up, missing the last week of fall weather and pretty leaves, about not enjoying your time outside. Thanks to the way the windows had heavy mesh on them, then blinds that nobody could control, we couldn't even see outside much of the time.
I had a long talk in the evening with another patient, the one I liked the most and who I was most upset about leaving on Monday. He was new to all this, so he had a lot of questions for me about my experiences, etc. He also told me how much better I looked that day, so much less haunted. That was such a good word for how I had looked. I literally was afraid to see myself for the first 4 days because the look in my eyes was bad. If Dr. Mind had seen me look that way he would have had me inpatient without hearing one word. I was so glad to find out that a lot of my frustrations weren't just me, including this nurse I really disliked (more on her eventually too).
That was a lot of writing. I think that shows how much better I felt; I could analyze the day and how I felt. Finally. I also was conversing by then, which was a big deal. I still don't feel like I can have any conversation I might want to because saying things isn't always easy. But that's just the thing where this takes more than 3 days.
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 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.
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:
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.
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