Since being diagnosed with bipolar disorder in 2006, I’ve spent my share of time in mental wards, with six total stays spanning six years. These visits have opened my eyes to the humanity of today’s mental health treatment methods, as compared to the stereotypes perpetrated in the popular media. Yes, you lose your freedom for a period of time. Yes, you miss your family and the comforts of home. Yes, you are deprived of many of your personal coping mechanisms. But it’s not as scary a process as it could be, thanks to modern pharmacological treatment methods designed to take you down from your psychosis and give you clarity of mind, enough that you can often avoid some of the pitfalls of being in a treatment facility.
A few caveats. I have never been in facilities that housed violent individuals. I have never undergone shock treatment. I have never been through drug and alcohol rehab, that not being among my problems. And I have been committed against my will only once. So I can’t speak to some things that others may have experienced in those situations. But I do know my own experience, including the learning I did that has enabled me to now stay out of the hospital for over three years.
The first time I went to the ward was very upsetting for me. By March 2006, I had been going through a depressive episode and that was when I had almost run away from home on a Thursday night.
The following Monday I went to an appointment at a hospital intake facility (only I didn’t know that’s what it was) like I would any other appointment. Bob went with me per Amy’s recommendation so that he could report what symptoms he had seen. We filled out paperwork and then went to see a counselor. After talking with the counselor, we were sent back to the waiting room.
After a while, the counselor called us back again. She told me that she had conferred with the doctor, and they felt that it was best that I be admitted to the hospital immediately. I was caught completely off-guard. I said, “I thought I was talking to you to see if I needed to be evaluated by a psychiatrist.”
She said that the treatment team had agreed that I needed to see a psychiatrist, but that they felt it would be best for me to see him in an inpatient setting. I looked at Bob, who seemed as shocked as I was. She asked me if I was ready to go to the hospital. I said no, I didn’t have anything packed or have any idea what to do to get ready for it. I reiterated that I did not know I was being evaluated for hospitalization. She told me what I would need for the stay and gave Bob a list of items that he could use to pack for me. She impressed on me that I needed to go into the hospital right now, and that Bob could bring me whatever I needed later on that day.
I started to tell her just how complicated my life was and what all going into the hospital would mean. She listened, and then she said she understood that, but that I needed a level of care that only an inpatient stay could give me. I told her I wanted to talk to Bob first to work out what we were going to do. She said that was fine and left us alone to talk.
I started crying. I had no idea what was going to happen. I had hardly ever been treated at a hospital except for having my children. Bob consoled me as best he could, saying that he would get his mom to help with the kids and that everything would be fine. He had me write a list of what I wanted him to pack, and I wrote another list of people he needed to call and let know I was going to be out of pocket for a few days—my editors, my parents, etc. After a while, the counselor came back and brought with her a handout explaining the rules of the ward and releases for me to sign so I could be treated.
After filling out all the paperwork, Bob and I followed the counselor to the door separating the ward from the rest of the hospital. I had my picture taken for identification purposes, and Bob and I were given a minute to say goodbye. He hugged me and told me he loved me. I started crying again. Then he left me to get packed, and I went on the other side of the door to be locked away for protection from myself, still crying.
I cried as I walked down the hall, and I didn’t stop for hours. I was shown to a room and had my blood pressure and vital signs taken. The intake nurse just let me cry through it without comment except she asked me if I had high blood pressure. I told her no. (I found out later that my blood pressure reading was 160/133, largely from the stress of the situation.) I sat in the room and cried alone after she left. I thought to myself that I had gotten into something I can’t easily get out of at this point. I resolved to be the perfect patient so I could get out as soon as possible to get back to my life. I would do everything I was told and let them know I was no longer a danger of any kind.
And that’s exactly what I did. I think that initial stay was about five days. I spent 24 hours on suicide watch then went to regular inpatient status where I was allowed to attend group counseling, individual counseling, and other ward activities with the rest of the patients.
After a while, I did enjoy the restfulness of the place. Enough activity went on that we were kept occupied, but it was a big change from normal life with three kids under the age of ten, a husband, a job, and a house and all the responsibility that came with that life. But I kept most of my turmoil inside, again in an effort to be sent home as soon as possible. I talked to Bob every night around 6 p.m.—we had a pay phone on the ward since cell phones were prohibited. He assured me that the kids were fine and everything was going okay. I don’t know how much of the truth he was telling. I know he continued to work, and his mom stepped in to take care of our kids as much as she could help. I felt guilty about that but knew that he didn’t have any other options.
Other people on the ward were very polite and nice to me, particularly those first few hours. We had an assortment of people that you might find anywhere—what we had in common was how unmanageable our lives had become. One was a nurse at St. Dominic’s who had been admitted through the same emergency room she worked in after being picked up by the police for tearing up her husband’s truck with a baseball bat. One older lady who was suffering from depression was very brave to talk to me as I sat crying at dinner the first night I was there. One was a young man who was on leave for psychiatric reasons from university—he was very articulate, well-spoken, and completely unaware of how dangerous to himself and others he was. Shortly after I was released, I heard he had died in a single-car crash after his parents signed him out of the ward. It was ruled an accident, but I will always wonder.
After I was released, my life didn’t change a bit. I went right back into the stress and strain I had always been under, although now I was medicated for the depression. After my psychotic break, I was put in a psychiatric hospital in northwestern Louisiana. This ward operated very differently from St. Dominic’s—after the morning rounds, our rooms were locked, forcing us out into the common rooms to interact with each other. I was on an acute intermediate ward, which meant I was around patients much sicker than I had been around in my last hospitalization.
. I did leave there after three days, but I was readmitted to St. Dominic’s immediately once my husband brought me back to Mississippi. This time at St. D’s, I was very open with the staff, looking for some magic formula from them that would help me out of the hell I had created for myself. I was there another week before my doctor felt I had stabilized enough to go home.
It was then that I was first tried on lithium, which worked like a charm but kept me constantly thirsty. I stayed stable on lithium until we had evidence that it was harming my kidneys—I was then but on a high dose of Abilify in conjunction with an antidepressant, Welbutrin, and the anti-convulsant Depakote. That worked well for me, too—until the next spring rolled around. That began a pattern that I followed until 2010—at some point between Valentine’s Day and Mother’s Day, I was hospitalized for depressive symptoms including suicidal thoughts.
Each stay was largely the same. We had morning devotionals, group therapy, individual therapy, free time, craft time, and social time. Group therapy involved sitting around talking with a social worker or counselor about issues that had brought us to the hospital. Some were struggling with bipolar symptoms, like me. Others had substance abuse issues. Some were suffering from schizophrenia, borderline personality, or unipolar depression. The group therapy sessions revolved around learning healthy coping skills, dealing with new limitations, or issues of grief and mourning.
Individual therapy was tailored to each patient. I spent a lot of time venting about my issues, ranging from poor self-esteem to obsessive thoughts. I met with the same counselor throughout my stay, and the counselors encouraged me to be more proactive in managing my symptoms so I could break out of the pattern of repeated hospitalizations.
Free time was indoors in the TV rooms or in other areas around the ward. Good behavior brought privileges, such as being able to go to the park area outside on scheduled breaks. Patients did a lot of sitting around and talking in the TV rooms. On one stay, a girl and I discovered we had a mutual love of Lillian Jackson Brown mysteries and spent our time talking about the various novels of hers we had read. Other activities included reading newspapers, magazines, or books that were available.
Craft therapy was intended for us to find new ways to spend our time. We could paint, do bead jewelry, draw, or entertain ourselves and others on a piano situated just outside the crafts room. We were evaluated for staying on task and completing our assignments. I did a lot of bead work—crafts were never an interest for me, but for some reason, stringing beads was very comforting and relaxing for me while I was there. I still have some of the bracelets I made there.
Social time consisted of simple games such as bingo. On one hospitalization, I had such a good run at bingo I was able to bring home a teddy bear for each of my children after winning them.
We also had the privilege of visitation on Tuesday and Saturdays. Bob would come and visit me; we could stay out in the TV rooms or go to our individual rooms for a little privacy, depending on the policies in place at the time. Bob and I usually talked about the kids when he would come visit for about thirty minutes each time, carefully making sure we kept the visits light and positive for both of our sakes.
I always went to devotion. Since it was a Catholic hospital, our devotions were conducted by the nuns each morning. On Sundays, a full church service was held for anyone who wanted to attend. My last hospitalization came on Easter Sunday in 2011, and I remember crying through it because I missed our church’s Easter celebration service, which was always a highlight of the year.
The biggest topic of discussion on the wards was always the illness. We would exchange medication stories, discuss various treatments we had been through, or talk about our experiences with psychiatrists, counselors, mental health centers, and group therapies. Before I was a freelance writer, I had worked for Social Security disability, and I was always giving people advice on filing for benefits, even helping one woman during one of my stays fill out her forms to file her application after she got out.
Other elements of the hospital routine are more medical in nature—blood drawn in the morning to check medicine levels and medicine given morning and night, depending on your personal medicine schedule. (I was once hospitalized for suicidal thinking and was discovered to have low levels of my Depakote in my blood, which resulted in my dosage being upped considerably.) You also get regular checks of vital signs—blood pressure, heart rate, temperature, weight, etc.
Mealtime and snack time are a big part of the day, too—smoke breaks used to be until so many hospitals went smoke-free. They offer a little bit of normal life to people in one of the most restrictive environments in the hospital. We went to the ward cafeteria for meals, while snacks such as ice cream, cake, or pudding were brought to us on the ward. Smokers who used to have the option of smoke breaks at St. Dominic’s now get nicotine patches once admitted to the ward.
Restrictions depend on your condition. Any drawstring pants, belts, or other sharp implements were banned due to suicide risks. I used markers and crayons to keep up with my journal while an inpatient. Suicide watch involves fifteen-minute checks for at least 24 hours once admitted. Violent behavior resulted in restrictions ranging from no outside breaks to complete seclusion on a more restricted ward—a sight I was glad to never see. The scariest sight I ever saw on the ward was a girl with a port in her arm for anesthesia for her electroconvulsive therapy.
My shortest stay was my last—I went in on a Friday, I believe, and was released Monday afternoon. I didn’t miss teaching because we had Easter break during that time. I remember wondering if that would be my last visit, since it was so short and easy to handle. In between stays, I saw my counselor and doctor on a regular basis in their offices—three-week or monthly visits with the counselor and every three to six months with my doctor.
On two occasions, I was involved in a treatment process called partial hospitalization—once after being discharged in 2008 and again in place of a hospital visit in 2010. I went to daily classes such as nutrition, counseling, group therapy, yoga, or grief counseling at an outpatient facility only fifteen minutes from my house. I attended for several weeks each time, learning more coping skills and interacting with patients judged not ill enough for full inpatient treatment. My sessions were attended by other professionals trying to get a handle on their lives, just like I was. Most were recovering from inpatient stays; others came back for “refresher courses” like me when judged not ill enough for full inpatient treatment. We were overseen by a psychiatrist and met regularly with counselors and social workers in the small group classes. Often we did projects, such as the time we were asked to draw a family tree and discuss those relationships. (Being from the country, my tree branches were a bit tangled, shall we say. Much hilarity ensued.)
My most productive treatments were the regular sessions with my counselor outside the treatment facility. I had met her in the partial hospitalization program but had heard about her from my first therapist, Amy. She was jargon-free, very down-to-earth, but challenging as well. She challenged me to see my problems as solvable, which my second therapist had not done. We worked through issue after issue, problem after problem, depression after depression.
We concentrated on my learning coping skills for managing my daily stress—that being one of the most common reasons I would wind up in the hospital. Sometimes bad news would send me there—such as my dad telling me he had been diagnosed with prostate cancer. Other times it would simply be an overwhelming amount of daily stressors, such as too many activities, stress in my marriage, or problems with the children. She taught me reframing techniques to keep stressors from turning into catastrophes in my mind. We tackled relationship difficulties, such as extended-family interactions and holiday stress.
We still don’t know why spring seems to be a trigger for me, unless it’s simply a reverse of what often happens with a condition called seasonal affective disorder, where people tend to get depressed as winter approaches. My depressions often have a manic flavor to them, with obsessions and illogical thinking complicating my treatment course.
Of course, my medications are a huge part of my treatment as well, keeping my brain chemistry in check so that I can apply logical thought to the problems I encounter. I’m currently maintained on two antidepressants, Pristiq and Buspar, a mood stabilizer, Geodon, an antipsychotic, Tranzodone, and an antianxiety medicine, Klonopin. A counselor in the hospital once told me that taking my medicine and keeping up with my followup appointments would be the two most effective means of staying out of the hospital, and I believe he was telling the truth. Medication noncompliance is a huge factor in relapses, while counselors can aid in helping the patient maintain gains and insights made in the hospital setting. I have experienced side effects of some medications, particularly sleepiness and weight gain. But the benefits so outweigh the side effects that I plan to stay on medications as long as my doctor judges that I need them—which is likely for the rest of my life.
Julie Whitehead currently writes and blogs from Mississippi at her personal blog. She has been a university lecturer, a disability examiner, and a freelance writer. She carries a diagnosis of bipolar disorder and blogs to create awareness and help others understand the disease and its effects.