Note: This is a serial blog. To start at the beginning, click on Chapter 1 – The Meltdown under “Categories” and start at the bottom.
I slept very little the night before I was hospitalized and woke up exhausted. I started drinking that day as soon as I got up. I was drinking vodka and lemonade, my drink of choice, and listening to a CD of depressing music. I have always connected to my emotions through music. When I was a freshman at the University of Arizona in 1985, I made cassette tapes of songs with depressing themes which sounded depressing. By the time of the Meltdown, I had upgraded to CDs. Some of the songs on the CD I was fixated on that day were “Torn” by Toad the Wet Sprocket, “Leave Me Alone” by New Order, “Start of the Breakdown” by Tears for Fears, and “Blasphemous Rumours” by Depeche Mode. These are some of the songs I used to connect with when I was especially depressed. Anyway, that morning I decided to visit my brother’s grave, in spite of the fact that it was winter and very cold at the cemetary. I sat at Eddie’s graveside and talked to him. The gist of it was that I wanted to die so that I could be with him.
By the time I met with Sharon at noon for our appointment, I was in a really bad place. I was feeling hopeless despair and dissociating on and off. It’s difficult to describe what dissociating feels like. It’s like I’m there but not really there, like I’m watching from inside my head what is going on around me. I don’t feel real. When I used to dissociate a lot, I would often self-mutilate by cutting myself with a knife. It was as if feeling pain counteracted the dissociation. I think the reason I didn’t resist when Sharon suggested the hospital is because I was so zoned out. Had I been myself, I would never have gone.
I have a Bachelor’s degree in psychology, and had worked in the mental health field for twelve years in various positions. My first job was as a houseparent in a group home for emotionally and behaviorally disturbed adolescent girls. This was a live-in position, meaning I slept at the group home on the days that I worked. I was responsible for the daily care of the residents, such as meal supervision, administering medications, transportation to and from school, shopping for food and clothing, and general supervision.
I also worked as a psychiatric technician in a residential treatment facility for emotionally and behaviorally disturbed adolescents. Their emotional or behavioral issues were too severe for them to be placed in a group home. The adolescents lived at the facility, usually for six months to a year. They attended school at the facility also. The kids at this facility were much more likely to act out behaviorally than those at the group home, and I often had to help physically restrain them.
I worked for over a year as a group facilitator in a partial hospital program for chronically mentally ill adults. This was a type of day treatment program which lasted five hours per day, and was held five days per week. Some of the groups I was involved in were the traditional style of group therapy, in which the patients discussed issues that were important to them, and received feedback from fellow patients. Others were educational, covering topics such as stress management, nutrition, and symptoms of depression. There were also experiential groups, in which the patients did an activity then processed it in terms of real life. The adult patients in this program were severely mentally ill with diagnoses such as schizophrenia and bipolar disorder.
At the time of my Meltdown I was working as a home-based case manager at a community mental health center. I worked with children who had been abused or neglected and their families. Often I went into the homes to work with the families. Many of the children had been removed from their families because of abuse or neglect. I performed a variety of tasks, such as transporting to appointments, teaching parenting skills, and helping people return their houses to a livable condition in order for them to attempt to be reunited with their kids. Sometimes, there was no plan for reunification, so I monitored the child’s progress while termination of parental rights was pursued through the court system.
Having had all these work experiences, the idea of being a patient in a psychiatric hospital was unacceptable to me, despite knowing I was deeply depressed and suicidal. When I got to the hospital, had I been myself, I would have been terribly anxious about the new situation and being around people I didn’t know. But I wasn’t myself.
The first thing I remember about being in the hospital was the body check. A body check requires you to strip down to your undergarments so the staff can make sure you aren’t hiding any contraband that could be used to hurt anyone (things like sharps, drugs, etc.). They also document any scars or marks on your body. I had been on one side of the body check in my career. Now I was forced to feel the embarrassment of being on the other side.
The Transitions Unit of the hospital held depressed patients and patients who had addictions issues, and was where I should have gone. But the first night I was hospitalized, I was placed on the Geriatric Unit because there was no room on Transitions. By the time I got to the Geriatric Unit, the numbness was wearing off and I was starting to face my new reality. I was soon horribly anxious and even more depressed because I realized I had hit bottom. It was one thing to be in therapy and on medication, but to be in a psychiatric hospital? How would people react to that and would I ever work in mental health again? Worrying about what people would think was one of the issues that I became focused on during this period. I remember crying a lot. I hadn’t been able to cry for so long, but now it seemed I couldn’t stop.
My roommate on the Geriatric Unit was an elderly woman who informed me that she was in the hospital because she tried to kill her husband. Nice…my first night in a psychiatric hospital and I had to try to sleep in the same room with a homicidal old woman. At least she seemed harmless. I probably wouldn’t have slept that first night anyway, but my insomnia was not helped by the loud moaning that went on during that night on the unit. Someone, maybe more than one person, moaned “Help me” over and over during the night. I thought “For God’s sake, someone help him!” It wasn’t conducive to a good night’s sleep.
The next morning, a bed opened up on the Transitions Unit so I was moved. I had a roommate on this unit also. I don’t know why she was in the hospital. All I know is that she had sleep apnea and was on a breathing machine at night. This ensured that I would not get any sleep on my second night in the hospital either. Fortunately, they moved me into a different room the next day.
Early every morning, usually between seven and eight a.m., Dr. Greene came to see me. We talked about how I slept and the status of my anxiety, depression and suicidal thoughts. He adjusted my medication as needed. Normally I wouldn’t want to see anyone at that time of day, but I wasn’t sleeping anyway, so it didn’t matter.
The main programming in the hospital was the groups, which started at 9 a.m. and went until lunch. They started again after lunch and continued until about 2 p.m. For most people, groups perform very important functions in a hospital stay. For one, they provide structure to the day, giving something positive to do instead of watching TV or sleeping all day. They get patients out of their rooms, interacting with others. They provide useful information as well as a forum to discuss issues with others who can relate.
The first group of the day was always Wrap-up, during which goals were set for the day. Wrap-up was also held in the evening, so everyone could report on how they did on their goals that day. I wasn’t sure what we were wrapping up in the morning. I didn’t care about living, let alone setting goals for the day, so I didn’t want to attend.
There was also Nursing group, during which a nurse usually did a general educational session on topics like coping with stress or anxiety, or the symptoms of depression. If I were myself I could have led these groups. I didn’t see the point in attending.
Another group was Occupational Therapy, held in the craft room which was on a different floor of the building, and was full of scissors and other sharp items. I couldn’t attend due to being on suicide precautions. It was fine with me, as I had no desire to make collages out of pictures I cut out of a magazine, or make key chains out of beads.
Participation in groups was important on the Transitions Unit, to the point that your privileges depended on it. This meant that your ability to go outside to smoke, go to the gym, go to the cafeteria, and go to the craft room were dependent partly on your participation. But, being on suicide precautions I couldn’t have any privileges anyway, so group participation was irrelevant. Because I had led groups for chronically mentally ill adults, I was horrified at the reality of being on the other side of this situation.
Another issue about the groups was the fact that all patients on the unit were included in every group. This meant up to twenty people who had very different problems were there. It was overwhelming to be in a small room with that many people. The rooms were not big enough and were really hot. Some of the people with drug and alcohol problems were scary. I didn’t want to leave the safety of my room. I was anxious already, and leaving my safe place to sit with a bunch of strangers and discuss my issues (which I wouldn’t even talk about with loved ones) was just not going to happen.
So I stayed in my room most of the time. I laid on my bed and did word searches or sat in the window alcove and stared out at the river. Needless to say, I wasn’t very popular with the staff when I refused to attend the groups. From my former work experiences I remembered how annoying it was when residents didn’t comply with some part of the program. It disrupted the routine for the staff. I am usually a compliant person and concerned that people like me. However, my normal personality went out the window during my Meltdown. I was irritable, which is also unlike me. I just really didn’t care whether the staff liked me or not. I was in a whole different mode and being a people person wasn’t part of it.
Despite how I felt, however, my group attendance dramatically improved once I was told that my insurance company was talking about not approving the hospitalization if I didn’t comply with the program. The thought of having to pay out of pocket for the expenses was enough to motivate me to at least attend some of the groups. I can only imagine the tens of thousands of dollars it would have cost had my insurance not covered it. Mostly, the groups were a positive thing once I started attending because they got me out of the isolation of my room, got me out of my own head which was an ugly place to be, and forced some interaction with my peers.
However, sometimes the groups were suspect in their content. For example, my “favorite” was one in which the leader brought in a guitar. There were maybe seven of us there, all women this time. One of the women was obviously deeply despondent and depressed, as she cried non-stop throughout every day. So the psych tech was playing upbeat, encouraging songs, which seemed to make this woman cry harder. It just felt mean to be singing “I Can See Clearly Now” in front of this sobbing woman. Next, the tech played “If You’re Happy and You Know It,” which seemed a little condescending with a group of adults, since I used to sing that song with my daycare class, for God’s sake. Needless to say, I didn’t participate in the clapping or stomping.
Another aspect of being in the hospital that I had an issue with was the nursing students who came for their psychiatric rotation. They walked around in a gaggle of five or six, dressed in their bright scrubs, chattering and giggling. They were upbeat and happy. As a severely depressed patient, I found them extremely annoying. Their chipper moods were an insult, and seemed disrespectful on a depression ward. I didn’t expect them to mope around like we did, but a little less happy would have seemed more respectful.
The best part of the day was visiting hours, because it was a brief distraction from the fact that I felt “crazy” and was in a mental hospital. It was also one of the hardest parts of the day. I say this because I felt like I needed to present myself as normally as possible to my visitors, not like someone who wanted to kill herself and needed to be locked up. I’m sure my visitors were anxious too, but it was still difficult. I was lucky to always get visitors. Initially it was Christi, my friend who took care of my cat, Epiphany, and a friend from work. Once I told my brother what was going on, he visited. My mom came every night once I told her where I was. I was lucky to have very supportive family and friends. It’s unfortunate that I wasn’t able to share with them what was really going on for me and utilize this support system more, but I was just used to hiding my symptoms from everyone. I was used to putting on a normal face to the world so nobody would realize that I was actually “crazy.”
It may seem contradictory that I talk about how close my family is, yet I chose not to reveal my hospitalization to my parents until I had been there for a couple of weeks. It was easier to tell my friends than to tell my family. A strong dynamic in my family is that we protect each other from upsetting information. Nobody wants to bother anybody. We even apologize when giving each other gifts. We say, “I have the receipt, you can take it back” before the person even opens the gift. When my dad was first diagnosed with oral cancer, I was a student at Indiana University in Bloomington. My parents didn’t tell me about the diagnosis for at least a week, until I came home for Spring Break, so as not to upset me at school. Throughout his several recurrences of cancer my dad minimized his symptoms with us, not wanting to worry anybody. He had appendicitis one year at Thanksgiving. He insisted that the rest of us go visit family as planned, and he stayed home alone. When he eventually went to the hospital, we found out that his appendix had ruptured and he could have died. I learned by example to minimize anything that might upset my family. Having grown up in this dynamic, it was just natural for me to keep my Meltdown from them.
It amazes me now that I was so irrational during my hospital stay. For example, I was surprised by things Sharon revealed to me that I said concerning suicide being part of natural selection, as well as other statements I made. I have no memory of saying these things. I was probably dissociating. I had never had psychotic symptoms, and I’m usually a very rational person. I guess it’s an indication of how depressed I was that I could convince myself my family would be less affected by my suicide if I killed myself around the anniversary of my brother’s death. In reality, they would have been devastated regardless of when I killed myself, and would have felt enormous guilt.
It’s the irrational thinking that made my cat, Epiphany, a bigger focus than my family during this time. It really was thoughts of Epiphany’s fate if I killed myself that kept me alive. I obsessed about what would happen to her. I couldn’t stand the thought of Epiphany living the rest of her life in a cage at the Humane Society, or getting euthanized. It was not irrational of me to be concerned about Epiphany’s well-being, but I am astonished now about how disconnected I felt from my family and everyone else back then. All I knew was, even though I couldn’t stop obsessing about killing myself, I needed to try to stay alive to take care of Epiphany. She needed me.