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By the third time you are admitted to an inpatient psychiatric ward, the process becomes almost routine. There’s the obligatory blood draw to test for drugs, the chat with the social workers, and then the meeting with the doctors who finally articulate what is painfully obvious to everyone around you: that you’ve completely lost touch with reality and need immediate, intensive psychiatric attention.
Then comes a long walk up to the psychiatric floor, the click of the doors as they lock behind you, and the profound disorientation of arriving in a strange and isolated bubble of society that few others will ever get to experience. Welcome to the loony bin.
All of this is familiar to me. At the age of 25, I was officially diagnosed with bipolar I with psychotic features. Although I fit the demographics of this disease perfectly (female, mid-twenties, previous diagnosis of ADHD), its onset in my case was frighteningly abrupt. I was a functioning graduate student in July working on my dissertation and planning my wedding. By September, I was in the university hospital psych ward.
There were many contributing factors to my madness: a family history of severe OCD and depression, an unhappy childhood, the pressure of my prestigious graduate program, and the stress of moving in with my fiancé, but the final straw was probably the enormous amount of brain power and abstract thought I was expending on in my dissertation. By the time classes started that fall, my mind had reached critical capacity and, for lack of a better way to describe it, my brain broke.
I didn’t know it at the time, but this was my first episode of mania. It wasn’t a totally unpleasant experience. The lack of sleep meant that I got a lot of work done on my research project, and my delusions of grandeur were not that far off from the cocky, self-assured affect common in so many of my academic peers. The downside was that I slowly started to lose my grip on reality.
In addition to the delusions of grandeur, I started to experience delusions of reference: the unsettling feeling that there is deeper “meaning” behind everyday coincidental and random occurrences. By the time I was finally hospitalized I was having visual hallucinations of colors, shapes, and shadows.
My first hospitalization lasted 12 days and was terrifying. Mental illness and hospitalization for any reason are scary as shit by themselves, let alone when combined. It being my first experience in the psych ward, I had no idea how things worked. Activities as simple as ordering meals, getting clean clothes, and taking a shower seemed complicated and difficult.
It took a while, but I gradually started to regain my sense of reality and of the boundaries between myself and the outside world. I was released to the care of my fiancé (who I am convinced deserves a medal for being the most patient and understanding man on the planet). At this point I had no real diagnosis: My temporary label was psychosis and mood disorder not otherwise specified, which means “we have no clue.”
Within a few weeks of being released, my mania and psychosis had cleared up, but I had slid into a downward spiral of depression. The second hospitalization occurred after I swallowed a handful of Benadryl in a misguided attempt to take a nap. This visit was much shorter: only three days. I was put back on medication for my ADHD, which improved my mood substantially because, even when you’re completely nuts, untreated ADHD still sucks.
A few weeks later I saw a new psychiatrist who strongly suspected bipolar disorder and prescribed a mood stabilizer. She told me that it could cause a rash but not that it could cause mania, especially if other mood-stabilizing antipsychotic drugs were not taken with it.
A few weeks after that (for reasons only a crazy person can understand) I quit taking most of the drugs I was on. I then lost the ability to distinguish between my dreams and reality and ended up in the psych ward for my third and most recent visit.
By this time around I was familiar enough with the place that, after I regained my senses, my worst complaint was the soul-crushing boredom. Contrary to the image presented in Girl, Interrupted, socialization and camaraderie were quite rare at this hospital. Patients were either not crazy enough to want to make friends in the psych ward or too crazy to carry on a decent conversation.
My third stay was an exception to this. It was during the holidays and the ward was a special kind of depressing. This magical mood brought many of us together to commiserate and bitch about how the staff should really take down the tiny Christmas tree in the library because it was bumming us out. We talked meds, diagnoses, and tragic life stories, but most conversations eventually devolved into penis jokes and commentary on the relative hotness of the male nurses (we were almost entirely women and gay men).
Dirty jokes, board games, therapy groups, and visits from my fiancé only got me through so many hours of the day, though, so I cultivated several other hobbies that helped pass the time. My favorite was observing and analyzing everyone’s clothing choices.
Unlike the rest of the hospital, psych patients are allowed and even encouraged to wear their regular clothes. This is within certain limitations, of course: no belts, no shoelaces, no drawstrings, and nothing “suggestive.” One of my next-door neighbors, a detoxing heroin addict, had a total meltdown because I was allowed to wear leggings while she wasn’t. To be fair, she did have a rockin' bod that, legging-clad, probably would have been “distracting” to many of the male patients.
Because people frequently came into the ward in various states of undress, the newest patients were usually clothed in full hospital attire: a gown, pale blue scrub pants and hospital socks. People who had been there for a while usually wore a combination of their own shirt and socks with hospital pants. Some eventually discovered that you could ask for dark blue scrub pants that looked less hospital-y and more like jeans. By the time you had your shit together enough to be wearing clean, matching street clothes complete with socks and shoes, you were usually getting out soon.
One of my few sources of pride about my hospitalizations is that I flouted all of these sartorial conventions. I hated hospital clothes and devised an elaborate system of daily laundry and strict clothing separation in an effort to be wearing clean street clothes as much as possible. I even had a cute little skirt and leggings combo going on. The nurses called me "Miss Fancy."
My last visit to the ward lasted 13 days. I was finally given a real diagnosis, stabilized on a decent cocktail of meds, and released back into polite society. Being released from the hospital feels great, but the challenges I faced were far from over.
I spent two weeks in a partial hospitalization program that was very much like day care, but with more viewings of Silver Linings Playbook and discussion of feelings. I’m still working on finding a combination of meds that works well but doesn’t make me drool or give me the shakes, and I’m working through my dark and twisty brain insides and learning better coping skills in therapy.
I’ve had to take a semester off school and push my wedding date back a year to give my brain an opportunity to rest and de-stress, but things are finally looking up. My mood is stable, my thoughts are clear, and I’m able to access some higher order skills like reading and writing.
I’m choosing (very consciously) to share this non-anonymously for two reasons. First, I find it empowering to own my diagnosis without fear or shame. My illness is what it is and I don’t feel that I should be any more secretive about it than a person diagnosed with diabetes or cancer would be.
I’m also doing it for the usual awareness and consciousness-raising reasons. The more of us that share our stories openly, the less room there is for misunderstanding and fear to fester. Mental illness does not have to define a person or condemn them to a life of suffering; it can, like any illness, just be a bump in the road to a fulfilling and happy life.