The Positivity Kit

Eleven days ago I called the hospital where I had my two November inpatient stays to ask about admitting myself.  Ever since my psychiatrist failed to tell me that my latest suicide plan was non-fatal, I’ve been obsessed with dying.  I didn’t want to die.  I have so many things to live for.  I just feared the 10% chance that impulsivity would overtake me and I’d wind up dead.  Just as I was feeling I needed to go to the hospital, Sadie told me that Sierra suggested a therapy vacation.  (As it turns out, she only meant individual therapy, not DBT group, and DBT group is what I was actually burnt out on.)

So I was in the three week time span of this “vacation” when I called and asked if I could be admitted.  The hospital is in a neighboring state, and the admissions nurse was prepared to have me drive up there and come in, until she found out I have out-of-state Medicaid.  She told me they absolutely would not admit anyone under those circumstances.  Except…I was there twice last fall, with the same insurance situation.

I called again the next day, hoping someone else would give me a different answer.  It took over two hours to receive a call back, then that nurse said she’d need to transfer me to the financial department.  I left a message there, and never received a return call.  Around 6 pm I had mom take me to the local ER, in hopes that the staff there could facilitate a transfer as they had in the past.

I met with an on-call therapist, Charles, who I had previously met and hated.  He didn’t think a 10% chance of suicide was worth worrying about, but it’s not his call, and the on-call psychiatrist disagreed.  The plan was to try getting me admitted to the hospital I’d called, and if they wouldn’t take me I’d be willing to be admitted locally.

That’s not what happened.  Through a series of lack of communication and being bullied by ER staff, I ended up at an unfamiliar hospital in my state, but two-and-a-half hours from home.  I had been prepared to tell the staff at my preferred hospital to keep me at least a week no matter what I said trying to convince them otherwise.  I know me.  I know I will try to get out.  That’s exactly what I did at this new hospital.  I didn’t even give it a chance.  I just freaked out and in less than 24 hours had signed an AMA form (to be discharged against medical advice).

The psychiatrist who saw me the next day said that, since I actually wanted to leave Monday, I needed to fill out the form again.  This made no sense to me or to any other staff, except that one nurse suggested he was using it as a loophole, because he had to choose between discharging me AMA or getting a 72-hour emergency detention from a judge and maybe he really disliked both options.

At any rate, I saw the normal weekday psychiatrist for the first time on Monday, and by 9 pm Monday night I was back home.  I knew almost as soon as I left that this was a horrible mistake, and it doesn’t seem like my mom even cares.  The closest she came to seeming concerned was to interrupt a sobbing meltdown yesterday to ask if she needed to call 911, to which my response was, “That would land me in jail because I would fight their asses.”  I would.  I adore cops, but there is no way in hell I am ever letting one take me to a hospital again.

So where does the “positivity” in the title come from?  Well, to explain that I must first explain the turtle.

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On Sunday we had the option of leaving the unit for art therapy.  This is normally my favorite part of any inpatient stay.  Not so much this time.  The art room was crowded with furniture and way too many people.  The tables were filthy with paint smears and plaster dust.  Then, instead of announcing a project, the art therapist gave us a quick tour of what was in every drawer and cabinet, and told us to engage in free expression.  I was anxious in that room and overwhelmed by the choices.  I chose the fuse beads because those supplies were already sitting out, on a table away from the rest of the crowd.  I had my turtle ready in record time, then asked if I could please stand in the doorway because the room made me anxious.  They went so far as to let me sit on the floor in the hall.

I looked at my turtle all the time during the rest of my stay.  Despite the suffering associated with him, I think he may be my favorite thing I’ve ever made in a hospital.  Then I stumbled upon a book titled The Positivity Kit by Lisa Currie.  It was marked on the front that we should have copies made rather than writing in the book.  As with the art room, I was far too overwhelmed to choose pages, so I asked a staff member to copy four or five random pages for me.  When I got home I ordered the book for myself.

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I have yet to even write my name on the first page as the book instructs me to do, but I hope to make it a colorful reminder of happy memories and wishes for the future.

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Stolen Freedom

On Monday I had an appointment with Sadie.  I wanted to summarize the week since I’d last seen her before addressing my real issue, which was a friend who was staying with me.  I didn’t even get to summarize the positive parts (including seeing a play and going to a sober prom), because I briefly mentioned a suicide plan I’d had for about two days, and that led into a lecture on needing to adjust my attitude so that I can be content within my current life circumstances.  45 minutes of lecture, and then Sadie completely blindsided me by wanting to send me to inpatient.  I didn’t need that.  I was not in danger.  I had pills on hand, but did not intend to use them.  In the past she would have had me call my mom to dispose of them, but this time she leaped straight to inpatient.

I specifically said I didn’t want to go to the inpatient unit affiliated with her organization.  So what happened?  She contacted my psychiatrist and arranged for a direct admission to the very inpatient unit I didn’t want to go to.  I had a 10 minute time limit to arrive at the main center before the police would be called.  Don’t think I didn’t look at my gas gauge and calculate how far away I could get if I fled.  But I did what I desperately did not want to do and drove straight to the main center.  My psychiatrist spoke with me for about 10 seconds, reiterating her decision to admit me despite my objections, and then I sat in the waiting room for THREE HOURS AND THIRTY TWO MINUTES.

Initially I was waiting with a friend who was also being admitted.  They even ordered us lunch trays from the cafeteria and we ate them in the waiting room.  My friend had arrived first, so he was admitted first, leaving me to wait there alone.  When I finally got admitted, I saw that a “friend” who had gone missing weeks ago was there.  I do like her, but I don’t consider her a close friend, and guess what?  She found out I was about to be admitted and told all the staff that I was her best friend.  I quickly corrected that misconception!  She would not leave me alone, even when I specifically stated that I’d like to be alone.  She would not let me visit with my mother in peace or eat in peace or journal in peace.  I hid in my room whenever possible to avoid her.

Every time I spoke to a staff member I had two things to say: that I didn’t belong there and that this other patient was causing problems for me.  On the first full day, the nurse who went over my treatment plan hinted that leaving that day might be possible, but my psychiatrist said, “Maybe tomorrow, but that’s not a promise.”  I was asked if it was okay for a certain other patient to move into my room with me, and I didn’t feel like it was a real choice, so I said okay, before realizing that her psychotic ranting would keep me up all night.  When I tried to hide in my room to get away from the first problem patient, she came in and was talking about murdering people, and was not completely caught up in her hallucinations as she made references specifically to what I was doing and wearing.  I was terrified.

I didn’t know what to do.  I just wanted out of there as fast as possible.  I went to hide in the back bathroom, where I screamed at the top of my lungs.  Jan, the prior on-call therapist who has been covering some shifts lately, ran out of her office saying, “Did anyone else hear that?”  The staff said no, some patients said yes.  She went around locating patients and I heard her ask where I was.  A moment later she was knocking at the bathroom door and calling my name.

I ran out, frantically saying, “You have to get me out of here.  There isn’t anywhere safe.”  After we talked, she said that she would talk to the staff about letting me sleep in the quiet room that night.  The quiet room is scary too – restraints built into the bed – but still less scary than spending the night thinking my roommate might strangle me in my sleep.

When evening came, I asked the nurse who brought my meds about sleeping in the quiet room.  He said, “I don’t think that’s going to be possible tonight.”  About 10 seconds later I was invited out for snacks and a different nurse informed me that I didn’t need to worry because they had moved my roommate again.

I did manage to go home after two nights, but that’s two nights of my life that I can never have back.  I don’t understand why Sadie felt the need to send me there.  I thought she knew me well enough to know that if I need to be in the hospital to stay safe I will be the first person to say so.

Also, that particular inpatient unit, which I didn’t want to go to, is completely useless.  No actual treatment takes place, and it’s basically like the drunk tank in jail.  They lock you up until they think you’ve sobered up.  The real tragedy here is that I no longer trust Sadie.  I have always been honest with her, even sometimes sending an e-mail if I accidentally lied by omission, but I know there are going to be intentional omissions now and therefore therapy is a complete waste of time for both of us.  She will never again be the person I confide in when I’m feeling really down.  This is exactly the opposite of what she’s been trying to accomplish with pushing me to express my emotions and not put on a smile to make everyone else feel better.

I hate this.  I hate all of it.  I had asked my psychiatrist if I could become a meds-only client and discontinue therapy, and Sadie’s response was that I was obviously angry with her about something.  I was, but that wasn’t the whole story.  The few weeks I managed to not see her were some of the best weeks of my life.  I know therapy isn’t meant to make me feel good, but I shouldn’t leave feeling a thousand times worse than when I came in.  There’s something wrong if I am in a great mood when I arrive, and then go sob in my car after the appointment.

Top Reads of 2017

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2017 was a light year for reading.  I had to make my way through several lengthy textbooks and that plus the struggles I had with my mental health led to not reading nearly as many books as in recent years.  Thus, I only found three to be highly recommended.

  1. The Buddha and the Borderline by Kiera Van Gelder – A memoir about recovering from Borderline Personality Disorder, this book artfully describes the reality of living with the disorder and how Dialectical Behavior Therapy (and its roots in Buddhism) led the author to a more manageable life.
  2. Turtles All the Way Down by John Green – This is a mystery in the vein of the author’s past book, Paper Towns, only the main character spends much of the time caught up in “invasives” – the obsessive thoughts that Obsessive Compulsive Disorder is named for.  The descriptions of her thought processes are very poetic and insightful.
  3. No Mud, No Lotus by Thich Nhat Hanh – Inspired by The Buddha and the Borderline, I began reading books on Buddhism.  Among several books I read in a short span, this one on relieving suffering helped me the most.  In DBT group we often discuss how rumination turns pain into suffering, and I have a strong tendency toward rumination.

Running

I haven’t blogged in 3 months. When last we met, I had recently been released from the local inpatient unit where I have always gone for treatment. While there, I ran into one of my former clients, and the on-call therapist who had admitted me didn’t seem to care.

Fast forward to October and my former employment was suddenly a problem. I went for so many emergency assessments and kept being sent home. At one point I ran away during an assessment and was certain the police were chasing me. My mom took me back, but after a long wait, when they were just about to admit me, the receptionist butted in to say I was supposed to call a facility 2 hours from home for a phone assessment so they could transfer me there. Ages later, that place hadn’t returned my call and mom stormed out, taking me with her.

Not long after that I overdosed on 3 days worth of my meds plus a handful of Valium. I was not conscious enough to know what I was doing when I signed paperwork in the ER and agreed unwittingly to go to a facility 1.5 hours from home. It was much like I imagine prison life, and I mainly got through it because Bree was there too. I put in my mandatory 5 days and was offered a choice between going home and checking myself in. Obviously I went home. The only benefit to that facility was that my aunt and uncle lived nearby.

The next month was October. Sadie wanted me back in the hospital and this time I was prepared to choose one for myself. I went to a very well-known and well-respected facility in the next state, less than an hour from home, and it was a great and helpful place. However, I was discharged as soon as I rated my depression a zero one day. I know my moods don’t work that way, but I didn’t argue because I had a wedding and an honor society induction that I didn’t want to miss.

When I admitted to Sadie that I had left too early she sent me back. My moods were all over the place. I ran away from the ER while waiting for transport, so they took away my clothes. I came down with a nasty cold the day of my admission and I was badly behaved while there. I’m so ashamed of how I acted and the fact that I left too soon again and turned down the follow-up treatment I was offered. It was hard to be both mentally and physically ill at once.

I managed to complete 7 of my 12 credit hours without losing my 4.0 GPA. The other professor gave me an incomplete and I have until the end of Spring semester to finish.

Lately all I’ve done is wish I were back in the hospital. The last time the on-call therapist arranged a transfer for me she said, “We have to break the cycle of you taking up a hospital bed every time you want to run away from your life.” It hurt a lot and was the reason I ran away from the ER. My irrational brain twisted that into thinking someone else would die if I took that bed.

I have an appointment with Sierra tomorrow since Sadie is on vacation and I really don’t know what to expect. I run from my life but I also run from treatment and Sadie has no idea what to do with me anymore.

Bree

Every time I have a stay in the inpatient unit there are one or two people I really connect with and we exchange contact information to stay in touch.  In my most recent stay, one of these was an 18-year-old girl I’ll call Bree.  Bree was depressed and suicidal and had a tendency toward self-harm.  She had been there for two weeks, and spent the past week sleeping in the “quiet room” so she could be monitored more closely.  I shouldn’t be impressed by this, but she fought the staff and it took four of them to hold her down – she had a real fire in her, despite the depression.

Nearly another week later, on Thursday, Bree was released despite telling the staff that she wasn’t ready to go.  She immediately began messaging me on Facebook to talk about how scared she was to be at home because she was still suicidal and didn’t understand why they sent her home.  I talked with her nearly continuously all evening, and again the next evening.  On Friday night she attempted suicide while talking with me.  She had taken an unknown quantity of an unknown combination of pills, and the moment she said she had taken them I called for help.  I didn’t know her address, but I called the inpatient unit and asked them to call 911.  13 minutes later she stopped responding, after sending a final message of “I’m started to feel funny.”

I have to assume that the inpatient staff took me seriously and that help arrived.  I have to assume that she was taken to the hospital and her physical symptoms were managed and she was readmitted to the inpatient unit.  I have to assume these things because the only way I’ll ever know that she’s okay is if she messages me again, which could be weeks or even months from now.

I know that I did everything I could, yet I still feel like I failed her.  Like when she refused a ride to go back to inpatient, I should have offered to come sit with her.  Or when I woke up Friday morning, I should have messaged her immediately instead of waiting until she decided she wanted to talk.  I feel like there was something I said, or something I didn’t say, that would have made a difference in her decision.  I know this is unreasonable.  I know she was in pain she thought she couldn’t bear anymore, and nothing I said in a Facebook chat was going to magically fix that.  It doesn’t prevent me from thinking about her non-stop, unable to concentrate on anything else.

This Isn’t an Empty Box

I created this collage about the experience of recurrent mental illness: how it destroys the positive aspects of me and how even when I do just what the doctor ordered I still have symptoms.

The blank space is for anyone else who is struggling to tell your own story. Make your own collage. Draw. Write poetry. Keep the conversation going about how mental illness impacts your life.

Vacation Valium and College Chromebook

Late Saturday night I returned from a week+ vacation to Walt Disney World.  I had planned very thoroughly to fit in all the rides and shows and parades and random street performers, and then my mom encountered a medical issue and plans flew out the window.  We still had fun, we just didn’t get to do nearly as many of the fun things we expected to do.

Two days before vacation I had finally managed to get my follow-up appointment with the psychiatrist, and she prescribed Valium.  I was very nervous about taking it, fearing that she’d think I was taking too much, even though in reality I kept it down to less than half of the amount I was allowed and haven’t touched it again since returning home.  I really just needed help getting through all the crowds and stress of vacation.

My other stress was that I originally was scheduled to be taking a class right up to early August and we planned vacation in the short gap between the end of that class and the beginning of fall semester.  It turned out I couldn’t take that class and had a couple of months off, but vacation was already scheduled and paid for.  So I spent a lot of time receiving e-mails from professors about syllabi and Blackboard sites, and panicking that I couldn’t be at home preparing for the new semester to start.

On our way home we spent the night with my grandmother’s cousin and her husband and they were kind enough to let me print my syllabi and start writing assignments in my planner.  I still have one class in which the syllabus is not available (the semester starts today!) and my planner is already crammed full and I don’t know where I’ll fit those assignments.  I’m feeling very overwhelmed by the fact that I decided to enroll full-time this semester.

As we were riding in the car and I was trying to look at e-mails and Blackboard on my tiny little phone screen, I got very frustrated.  There was a simple assignment that needed to be written in Microsoft Word and uploaded, and I could have done it in the car if I could just figure out how to actually edit a Word document on my phone.  I also remembered that even as a part-time student I have struggled a lot with access to the computer.  I’m at my best academically when I first get up in the morning, but that’s the same time that mom plops down in front of the computer and goofs around online for 2-3 hours straight.  When I have to watch hours of video lectures and write on discussion boards and write papers for 12 credit hours of classes, there is no way this is going to work without me wanting to strangle her.

So I did the one thing I could do on my phone: read a bunch of articles and selected a convertible laptop/tablet.  I had very quickly decided it would be some sort of Chromebook, and my criteria were that it needed both keyboard and touchscreen, needed to be as small and lightweight as possible, and needed to be capable of running Android apps.  I found the Asus C100PA-DB02 Chromebook Flip.  It opens as a laptop but can be bent all the way back to use in tablet mode, or left partially open in a couple of ways so that it will stand up.  With a 10.1″ screen and weighing 2 lbs., it definitely meets my easy portability requirement.  And this is one of the few Chromebooks that has access to Android apps built in without having to enter a special Developer mode.

Our mail was on hold during vacation and I’m supposed to go pick it up this morning.  The Chromebook just arrived at the post office a couple of hours ago so it should be in the delivery that comes out around noon, but I’m hoping I’ll be able to snag it from the mailman when I pick up everything else.  T-minus 65 minutes until the post office opens!