Glimpse 2: In the Beginning

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 and nurses are also changed for privacy.

In late February 2009, my first psychotic episode occurred.  I had seen a psychiatrist a couple weeks previously and she had told me that she wasn’t sure of a diagnosis yet but she decided to try me on Risperidone, an atypical anti-psychotic.  On the last weekend of February, I saw my therapist.  Looking back I suppose that was the day that the psychosis first started to get me.  The session was rough and when I left, I had strong suicidal urges.  I got home and emailed my therapist, telling her that I wanted to kill myself.  She immediately tried to call me but I refused to answer the phone.  I was too scared to hear what she might say.  She emailed me back promptly and asked me to come back to the counseling center but I refused.  I told her I had to go to work.

As I drove to work, an ambulance went speeding by me.  I was afraid that ambulance was for me and that it was going to my apartment to try and save me.  When I got to the entrance to the shopping center that Petco was in, a police officer also drove his car into the parking lot.  I was positive that officer was looking for me and was going to arrest me so that I couldn’t harm myself.  I believed that all over town, police officers and paramedics were searching for me, trying to stop me form killing myself.  I was psychotic.  I was paranoid.  I was terrified.

I got through my six hour shift.  I tried to avoid the customers in the store because I was afraid that they were all undercover and would take me away if they figured out who I was and what was going on.  The next day, a Saturday, I went to work in the same condition.  Unfortunately, it was impossible to completely stay away from all customers on such a busy day.  I don’t really remember what went through my head that day.  Sunday morning, March 1st, I had to be at work at 7 in the morning to open the store.  I woke up at six and knew that I couldn’t do it anymore.  I wanted to kill myself.  I couldn’t bear the idea of another paranoid day at work.  I was exhausted from constantly fearing that people were out to get me.  I was not thinking clearly at all.  I woke my fiance up, Adam, and told him that I wanted to kill myself…I needed help, badly.  He called the crisis line at the local psychiatric hospital and they told him to bring me in to get evaluated.  I got dressed and away we went to the hospital.

I was evaluated by a very kind lady, she has evaluated me many times sense.  I don’t remember how this particular evaluation went.  I was too disconnected from reality.  I was shutting down.  The evaluator called the on-call doctor (who happened to be my psychiatrist).  My psychiatrist remembered me and stated that she wanted me to be hospitalized.  They allowed me to give my cell phone, wallet, and jewelry to my fiance before they took me back on the ward.

Once I got on the ward, I was even more scared.  I fell right into the stigma of psychiatric hospitals and their patients.  I was afraid that some psychotic patient was going to try to harm me.  I was afraid that patients would be mean, violent, scary…everything my paranoia told me about typical people in the outside world, but multiplied because these were not typical people.  What I didn’t see was that I was the psychotic patient, not them.  Most of the other patients were there because they were depressed, suicidal, or bipolar and struggling with mania/depression.  I didn’t realize this though.

My vitals were taken and I was led to my room.  The nurse carried some blue scrubs with her and told me I needed to go into the bathroom and change into the scrubs.  This was a small kindness I would later learn, protocol is that you change in front of the nurse.  Once I was properly outfitted, she waved a metal detecting wand over my body and found nothing.  She then asked when I had last ate.  I told her I had eaten lunch on Saturday.  A few minutes later as I was sitting in my bed in a bit of a daze, a tech came in and brought me a bowl of cereal, milk, and juice.  I ate in my room and then simply sat in my room until group started.  I had arrived at 7am and group was at 9am.  Group was officially the point in which I stopped talking.

In Group, people go around the circle of chairs and say why they are in the hospital and how they are doing that day.  I couldn’t focus on the people.  The ceiling had my attention.  I counted the ceiling tiles and then made patterns out of them that veered around the large fluorescent lights that also buzzed in a distracting manner.  When the therapist in charge of group got my attention by calling my name and asking me why I was in the hospital, I simply continued to recount the tiles, making sure the first count was accurate.  I felt no need to respond to anyone else.  For the rest of my stay, I continued to have problems in Group.  Sometimes, I was attempting to count the ridges and valleys of an accordion style room divider that stretched the length of the room’s left side.  Sometimes I would hallucinate.  At one point I saw water dripping from the ceiling yet there was no water stain on the ceiling panel and the floor was not wet.  I stuck my hand out to catch a drop of water and it simply vanished through my hand.  Other times, I would be delusional.  A window in the room allowed patterns of light to hit the floor.  One of these patterns got very close to a patient’s foot and I was afraid they would catch on fire if the sunlight touched them.  However, none of these experiences gave me any reason to talk.  Talking seemed dangerous.  I couldn’t get my thoughts organized enough to come up with any description of how I felt.  People seemed like unnecessary things to interact with.  How could they help me find new patterns in the ceiling tiles or make sure that people didn’t catch on fire?  They couldn’t…so why say anything?  It was safer to simply stay quiet.

After Group, I returned to my room and simply sat in there alone, lost in my psychotic thoughts.  I established a pattern of not leaving my room unless a nurse or tech came to tell me that I was needed for something.  I went to Group but didn’t participate.  I went to lunch, but I didn’t sit near the other patients.  The only time I participated in something was during Activity Group.  There, the Activities Coordinator, Angie, was a person who had used to work with my mom.  I remembered her slightly but it was enough to make a connection.  I still wasn’t talking but she figured out, you don’t have to speak to play cards.  As often as she could, Angie got out the deck of Phase 10 and we played it for an hour.  Sometimes with other patients, sometimes just me and her.

Whenever I saw my psychiatrist or my therapist, those were the few times I talked.  I remember with my psychiatrist I mostly gave one-word responses.  I simply couldn’t communicate how I was feeling or what was going on in my head.  I didn’t understand it.  My thoughts distracted me and took me inside myself where the words of those around me made no sense.  I was best able to answer short questions that didn’t require a lengthy response.  For most of the time I was in the hospital, my psychiatrist was trying a variety of medications on me.  For each new anti-psychotic, a new side effect occurred.  One day I might be so dizzy I thought I would simply fall over if I didn’t hold on to something.  The next day I might feel nauseous, worrying that at any moment I might vomit.  The next day my appetite might be obliterated and  I wouldn’t even feel the need to go to the cafeteria.

Even when they finally found a medication that worked relatively well, they didn’t send me home.  The criteria to send someone home, in a nutshell, is to make sure that they are experiencing no suicidal thoughts, homicidal thoughts, and no psychosis.  Since while I was in the hospital I had been told that my diagnosis was schizophrenia, I was in a sort of denial but I also knew that this diagnosis was going to change my life.  I didn’t want that to happen.  So while I had no plan to harm myself while I was in the hospital, I was afraid that if they sent me home, I would try to kill myself.  I wasn’t able to come to terms with this diagnosis in the beginning.

After a couple of days, it was my birthday.  In fact, it was my 21st birthday.  By this point I was talking a little to the nurses, and I was leaving my room in the evenings to accept visitors, phone calls, and to watch television in the day room.  On my birthday, one of the nurses came into the day room and sat down next to me.

“Do you know what is special about today, Katherine?”

“It is my birthday.”

“That is right and we have a surprise for you.  Would you be interested in seeing your surprise?”

I nodded and followed the nurse into the main open area.  There, all the patients were lined up around a cake.  As I moved into the room they all started singing Happy Birthday to me.  Then everyone got cake, ice cream, and soda.  This is probably my most memorable birthday ever.  Who celebrates their 21st birthday in a psych ward instead of with friends getting drunk?  I do.

One thing I also remember about this hospitalization is that I was afraid to let my parents know what was going on.  I remember I really didn’t want to talk to them.  I allowed my fiance to tell them that I had been hospitalized and why.  However, I would not let them come visit me.  I can’t remember if I would talk to them on the phone for a couple minutes or if that came during later hospitalizations.  I avoided them because I was ashamed.  I had always been their smart, goal-setting, creative daughter.  I was letting them down because suddenly I was dropping all my college classes, my goals seemed impossible, and I, in my view, was simply becoming a failure in life.  Why would they want to talk to me when I was in such a condition?  I didn’t believe they would.  I believed I had disappointed them very much.

This first hospitalization lasted 11 days.  Only towards the very end did I start speaking more often.  By day 8 or 9 there were still techs and nurses who would comment that it was the first time they had heard me speak.  I had some cognition problems due to the way my brain reacted to the psychosis.  I no longer could follow a conversation if more than two people were involved, including myself.  I could no longer read long passages in books or magazines while remembering or comprehending what I had just read.  As the medicine continued to bring me back more fully into reality, these problems would pass.  As the medicine continued to work though, I would not become stable for many more months.