Okay, I’m a day late for Thanksgiving. My brother brought home five international students which is always interesting (and hectic). My favorite part is when we actually eat dinner and they eat foods they have never encountered before. This year, a guy from South Africa tried cranberry sauce for the first time and he liked it! This is good because I LOVE cranberry sauce.
Anyways, I didn’t start a blog to ramble about cranberry sauce. I started a blog to talk about Thanksgiving. more…
Every so often, I’m going to start posting a “glimpse” at what life is like in a psychiatric hospital. These are true stories that I have lived through. Some of the dialogue may not be word for word but will capture the events as accurately as I can remember. These glimpses will also be in no particular order…just whatever I feel like posting. Names of other patients are also changed for privacy.
For two days I did not leave my hospital room. Psychosis had hit rather hard and I was convinced that if I left my room, one of the other patients would attempt to kill me. Only two patients were exempt from this thought: my roommate, Liz, and a particularly kind woman, Sarah.
I stayed curled up in bed, not even leaving at meal times. At first the nurses brought me trays of food but eventually they just left me alone in my room. In order for me to see my psychiatrist, one of the techs would wait until all the other patients were in group. He would then come tell me that no one was in the open area and it was safe to come out. Repeatedly, the nurses, techs, and doctors told me that I was safe…no one would try to harm me.
On the evening of the third day, Liz came in and told me that only her and Sarah were in the day room if I wanted to join them. My increased dose of medicine was kicking in and the psychosis was losing its grip. I decided to try my luck at leaving the room. Before this paranoia had hit me, I’d been working on a 500 piece puzzle in the day room. When Liz and I walked in, it was still there just like I had left it. Eagerly, I sat at the table and began working on it again. I was making good process. The puzzle was of a garden full of pink flowers and ropes of climbing ivy.
There was a commotion in the hall. Another patient, Rachel, had been in bad shape the entire length of my stay. She frequently became confused, sometimes stripping off her clothes or wandering into the nurses’ area. She babbled words that did not make sense and was never in a good mood. She was out in the hall, making some sort of ruckus. Suddenly, she came into the day room and headed right towards my table. I stood quickly and backed away from the table. She picked up the edge of it and attempted to throw it at me. Puzzle pieces went flying. A carton of milk spilled all over the floor. I disappeared…crammed into a tiny nook between the wall and a row of lockers.
Nurses rushed in, restraining Rachel and removing her from the room. I had immediately gone into a panic attack. The nurses, Liz, and Sarah could not calm me down. I’d been repeatedly told that no one would harm me, yet another patient had just thrown a table at me! Physically, I was unharmed but not for a lack of trying.
One of the nurses came in again to check on us. By then I had calmed down some but had not left my nook of safety. The nurse offered to put in a movie for us to watch then told us that she was going to lock the door so that we could leave the room, but no one else could come in without a key. After the movie, Sarah went to bed by Liz stayed with me. I didn’t feel safe enough to leave the room. Who knew when Rachel would attack again? She could simply walk into our room and strangle me if she wanted! The nurses never came to tell us to go to bed. Liz and I ended up turning out the lights and sleeping in chairs pushed together into tiny beds. Not until 6am did we finally return to our room. Even without the tendrils of psychosis, my paranoia was fed by the incident.
Today I took a huge step in conquering my biggest phobia: I got my teeth cleaned for the first time since I was 15 years old.
I often have talked about how careful I must be to monitor my stress. Stress leads to anxiety which leads to panic which leads to an increase in hallucinations/delusions/paranoia, which finally leads to outright psychosis and/or suicidal ideations and attempts. I’ve been lucky lately. I’ve been able to manage my stress enough so that I can prevent the cycle from getting past general and specific anxiety. General anxiety is simply anxiety that has been generalized to the world around me but has no specific focus. Specific anxiety is anxiety about upcoming events or anxiety as a response to individual triggers.
I’ve had plenty of triggers lately but I’ve been repressing a lot of my fears and worries so that I don’t have to deal with them. This is really a terrible way to go about things because eventually I must confront the sources of stress, but lately I have been unwilling to do so. There are two major areas of stress that I’m most concerned about. more…
I must apologize for my lack of posts lately. I have two excuses for my delay in a new post. First, I am working on a very special post that is requiring a lot of introspection. I don’t know when I will post it…it is something I am really having to reach deep inside to write and understand. Second, I am in the middle of working on a really big project. Unfortunately, I can’t talk about this project until I am given permission. But believe me, I really wish that wasn’t the case.
Those are my two excuses.
I realized, while re-reading the past few posts, that I have been neglecting to talk about Sheriff very much. I thought I would remedy this. more…
From the moment you are born, your life is governed by the schedules of other people. Then, a few years after being born, your life is governed by school. You wake up in the morning , go to school, learn, come home, do homework, eat food, and go to bed. If you choose to go to college, you accept this lifestyle through your early 20′s. You have to schedule the rest of your life around school.
Then, one day, you graduate and suddenly that lifestyle is over. You can do whatever you want, whenever you want. Of course, this does hinge somewhat on whether or not you work. I don’t have a job so I only see that side of it. As things stand now, I am unlikely to ever have a job. To me, that puts me in the ultimate seat of power. I control what happens in my life to a much higher degree than ever before in my entire life! But is that such a good thing? more…
I realized tonight that I’ve never written about my experiences with the very beginning of this illness.
There are three stages of schizophrenia: prodromal, active, and remission. Active is obviously what it sounds like, various positive symptoms are being experienced on a fairly regular basis and the person may be fully psychotic. Remission occurs when most or nearly all the positive symptoms disappear and the person is just left with the negative symptoms. Remission and active schizophrenia usually cycle with each other.
Remember what positive and negative symptoms are. Positive symptoms are symptoms that a schizophrenic person has but neurotypical people do not. These include hallucinations and delusions. Negative symptoms are a lack of qualities in a schizophrenic person that most neurotypical people do have. For example, a lack of motivation, a lack of interest in generally everything (including things that used to be enjoyed), a flat or blunted affect (monotone voice, lack of facial expressions), etc.
So that leaves the prodromal stage of schizophrenia. more…
When talking to a psychiatrist, nearly everything is question/answer format with little room for conversation. That is how I interpret it at least. Maybe some people out there are able to strike up an engaging conversation with their psychiatrist but I can’t figure it out. They ask questions that have very concrete answers. They don’t seem open ended.
“Which of your symptoms would you most like fixed?”
“The anxiety and the paranoia cause they make each other worse.”
“Okay, well I think we need to work with your anti-psychotic some then.”
That means change the dose. In my case, make the dose higher. I’ll be taking 16mg of Fanapt, a super new atypical anti-psychotic, a day. The maximum dosage is 24mg a day. It only has to be increased two more times before I will be at the maximum dosage. Then, if it isn’t working (which it currently isn’t), I have only two or three more options before the old anti-psychotics are tried. Things like Haldol, Thorazine, Navane, and Prolixin. I know that I still have Clozapine and Zyprexa to try but both are rather notorious for weight gain, sedation, and causing diabetes. Further, taking Clozapine and a benzodiazepine can cause respiratory arrest…hey that could be me. So really, I’m not open to even trying either of those medications. Which leads me back to the first generation anti-psychotics. They of course come with their own host of adverse effects such as acute dystonic reaction, stiffness, tremor, akinesia (decreased spontaneity), akathisia (restlessness…which I already have), weight gain, fainting, photosensitivity, Tardive Dyskinesia, and Neuroleptic Malignant Syndrome. None of those sound very worthwhile and are the reason that I will not hesitate to tell a doctor that I have no faith in anti-psychotics of any generation. more…
The brains of the mentally ill are damaged in some manner. Neurotransmitters are either overactive or not functioning. Synapses aren’t working correctly. Whole sections of the brain aren’t working as they should. Mirror neurons are missing. There aren’t enough neurons. Ventricles are too large. The cortex isn’t working properly. On and on, hundreds of theories regarding what is wrong with the brain to result in mental illness. The problem is, the human brain is so complex, that even the highest trained neurologists can’t comprehend how exactly the brain works…how complex it really is.
The same could be said about the mental health system because it is just as damaged as a mentally ill brain. Different clinics prefer to work with specific types of clients. Some clinics don’t want to be responsible for the patients who have severe mental illness or have a history of self-harm or suicide attempts. Some clinics have policies that border can be viewed as unethical and certainly are capable of stripping away the rights of the mentally ill individual. Some doctors would prefer to nearly incapacitate their clients with large amounts of medication simply to make them easier to deal with. Other doctors don’t really want to take clients who might require more than a 15 minute session every months. Here, the problem is, the people who need mental health services can’t always figure out how to get those services because the system is damaged…it doesn’t always make sense because it isn’t working properly. It is similar to a schizophrenic, we aren’t always rational because our brains don’t always tells us things that make sense.
Since my last post, I obtained an appointment with yet another mental health clinic in town. I went to the intake assessment in which my assigned therapist went over all the paperwork that I had to sign and then asked me a lot of questions to determine what sort of help I need, give the psychiatrist some background information, and develop a treatment plan with me. To the best of my understanding, getting an intake assessment means that the clinic is willing to provide you with services. Some of the questions asked involved how often do I hallucinate (daily), how often I have delusional thoughts (daily), the last time I harmed myself (August: non-lethal; June: lethal), the last time I was hospitalized (Sept. 2009), and what medications I am taking. The therapist appeared to be very concerned about my answers to these questions. I don’t quite understand some of that. She wanted to know why I wasn’t on anti-psychotics. Well, I functioned a lot worse when I was on them and they didn’t eliminate my delusions. They were also negatively impacting my physical health. So what was the point? If I am doing better while not being on those medications currently…why is there a problem with not taking them? Further, I am not completely against taking these medications. Currently, I wouldn’t really have a huge problem with it because I strongly feel that my brain needs a rest from such psychotic symptoms…I’m struggling a lot to keep everything together. I wouldn’t mind taking a break and allowing the medications to help somewhat with this…provided a better medication could be found that did not cause my level of functioning to plummet again.
Anyways, exactly a week after that appointment, I received a phone call from the clinic saying that my appointment for tomorrow with the psychiatrist had been canceled. It was canceled because I am seeing a therapist through my college and this clinics policies state that it is unethical for a patient to see more than one therapist. Hold on, when did I lose the right to decide what treatment I believe is in my best interest? The person who called me tried to explain why this is unethical. His example: a person has a phobia of spiders. One therapist works on desensitization and wants the person to hold a tarantula eventually. The other therapist feels that a phobia of spiders is rational and doesn’t need to be worked on. Okay sir, your example not only assumes that I would not take measures to prevent such confusion, but also assumes that I am dumb. Why would I ask one therapist to help me with a fear of spiders…then turn right around and ask the other therapist to help me with this problem as well? Why in the world would I subject myself to such confusion?! I wouldn’t because I know that by doing that…I would be wasting the benefits of having multiple therapists and I would be confusing myself. I informed this man that when my treatment plan was developed during the intake assessment, it was specifically decided that we would work on things that I am NOT working on with my other therapist! In response, he fumbled around and responded with something about how it just goes against the policies. Bullshit I tell you! Those are stupid policies and you know that I just proved that point! This man went on to explain to me that he would help me obtain services with another psychiatrist. Now, over the summer I called a lot of local clinics multiple times. Of all the psychiatrists accepted by my insurance, the one at this specific clinic is the only one accepting new clients…the others don’t even know when they will be accepting new clients again! So I asked this man, what happens if you can’t help me find another psychiatrist? His response, “I’ll broaden my search to include other states.” Huh? You feel it would be better for me to drive hours away to see a psychiatrist when there is one perfectly available in my own town? How is that for ethics?!
But this isn’t the only stunt this clinic pulled last week. See, I had already encountered the multiple therapist problem before…and I was under the impression that it had been resolved. The director of the college counseling services had spoken with the director of this clinic. An agreement had been made…I see a therapist at the clinic once a month and they will allow me to continue seeing my current therapist and still provide my with psychiatric services. Okay, agreed. But last week, the director changed her mind. So I spoke with her to see if perhaps she had forgotten about this agreement? She denied it had ever occurred. Yes, she spoke to the director at the college but he supposedly didn’t tell her I was seeing another therapist. She couldn’t tell me why the director of a counseling center would contact her if I was not seeing anyone at that counseling center. So I asked her what I was supposed to do to find another psychiatrist since this clinic was literally my last option. She told me, “that isn’t my problem.” She had also tried to explain to me that seeing multiple therapists was not therapeutically beneficial. I asked her if she thought that not receiving psychiatric care was more therapeutically beneficial. That made her angry. She proceeded to yell at me and told me, “I am not going to argue with you anymore. This isn’t my problem and I am through with it. Have a good day.” And then she hung up. I’m sorry…at what point in the education and training needed to become a director of a mental health clinic were you told that it is okay to yell at the mentally ill? I am being lectured about ethics and that lecture is concluded by yelling at me and being very rude? I think you are sending mixed messages Ma’am. more…
Officially, college classes started on Monday…I didn’t make it to class until Wednesday due to severe anxiety, sleep deprivation, and panic. I am painfully aware that I have regressed to some degree but more so in anxiety than schizophrenia…in my opinion. This semester, I am taking Advanced Horseback Riding (a passion of mine since I was a child, and although its been two years since I last rode…at that time I was actually training horses to do poles…like, ones that had never done them before. I am really quite talented at poles…or I was. I supposed the issue of if I still am will be addressed this semester. I am also taking Intro to Sociology online, Advanced Creative Writing (second to last class for my English/Creative Writing minor), Intro to Psych. Testing, and Bowling (which doesn’t start until March).
Unfortunately, when I finally managed to overcome my anxiety regarding class on Wednesday…I was not able to take Sheriff with me. Mondays and Wednesdays, my only class is Horseback Riding. Obviously, I don’t know what these horses have been socialized to in regards to dogs, Sheriff has never met a horse, and I certainly cannot ride a horse and handle Sheriff at the same time. My therapist had encouraged me to find something to focus on that would help me redirect my attention from the anxiety. So I taught myself a trick. Probably not a very healthy trick…but it worked nonetheless. I withdrew into myself so that the only thing that mattered was what the teacher said and exampled regarding pre-riding horse maintenance (really a review)…and mildly kept a bit of attention to Adam…because he was serving as my service human by making sure that I could stay near him and that I stayed safe in a state that didn’t allow me much awareness to my surroundings. I knew what the horse was doing that the professor was working with, I knew what the professor was saying and doing…but I was completely oblivious to the other students. I did my absolute best to avoid any eye contact with anyone excluding Adam…and I paid no attention to the environment around me. I hardly spoke and if I did…it was whispered to Adam so that he could answer my question or repeat it to the professor. Since I have been diagnosed, this is the one teacher that does not know that I am schizophrenic. I am worried that if he found out…he would question my ability or safety around the horses. For me, this is not a concern. I have been around horses since I was four years old. I know how to read basic body language, I know how to ride, I have some knowledge in training, and I know how to be safe around a horse. Besides, when it comes to my love of animals…working with a well trained horse is second only to working with a dog that is not necessarily well trained. So…I made it through that class. Today was a bit more interesting…because it would involve two classes…and Sheriff’s full return to a full day’s work since last semester. more…
