Continued from The Unit - Part 1 and The Unit - Part 2
Although I had talked to my spouse several times in the last 24 hours, I hadn't actually seen him since he left me at ER. Up until I was taken to the hospital, we had been in a cold war after a heated argument that took place the weekend before. Sometimes for a truce to be called, something major has to happen, and this was pretty fucking major. Forty-eight hours prior my admission, I didn’t even want to talk to him, and now I couldn’t wait until I was paged that I had a visitor. Visitation hours were from 6 - 8 PM every night and a couple of additional hours on the weekend. There were a lot of restrictions for visiting hours, as there can only be two visitors at a time and children are not allowed. I was over the moon when a crackly voice over my room intercom told me to go to the recreation room.
The visitation room was a combination of hope and despair. There was an elderly couple arguing in the corner, parents playing a game of Sorry! with their daughter, and an animated group of friends catching up. There were also people with their respective families sitting in silence, not ready to acknowledge the situation or just there out of obligation. All guests were searched before entering the room - cell phones, food from home, shoes with laces were all asked to be stored in a locker. My husband brought me a manual toothbrush, but the floss was confiscated - I would need to ask if I wanted to use it.
We had a good conversation, and we agreed to seek out couples’ counseling so we could improve our communication and relationship as a whole. He told me how Dr. B was skeptical of me and what I had told the team earlier. She felt I was holding things back. He told me about how our son wanted to be “sneaked in” to visit. He stayed until almost the end of the visitation hours, and I held back tears as I gave him a long hug.
On the way back to my room, I first stopped at the comfort room. The comfort room was a small room, available as a quiet space for patients. It was dimly lit with a chair and couch, aromatherapy and a large TV. I asked to be let in and walked into an amazing, welcoming and beautiful space. I grabbed the weighted blanket, sat in the chair and watching the soothing scenes on DVD. It was videos of the rainforest, animals, and waterfalls. Seeing these scenes reminded me of a recent trip to Starved Rock with my family, and I just started wailing. I had used crying as a call of despair the night before, but today I was using crying as a release. I was finally coming to terms with where I was, where I’ve been and where I needed to go. I just sat there while I cried hard and I cried for a long time. But, afterward, I felt better. I left and went back to my room to study.
I had no problems sleeping in the unit. The nurse came by with the medication cart to give me my new dosages of medication, and I was offered a sleeping aid, which I refused. I woke up the next morning to the blood pressure guy and then shortly after that to Dr. B coming by to check in on me. I actually felt fucking amazing. I don’t know if it was the medication or the reflection or something else but I suddenly had some hope that I had lost. She was happy to hear that I was feeling better and she informed me that Dr. A and her posse of students would come by at some point during the day to check on me.
After breakfast, where I had been given hard boiled eggs that clearly were not made following basic culinary standards, I decided to attend all the sessions that were on my schedule for the day. I first participated in yoga class where I learned that you can use full water bottles as weights and I colored a picture for my son during recreational therapy. I went to a mental health skills session where we watched a TED talk by Andrew Solomon on depression, and we had another patient-led group therapy session.
After my first group therapy, I became more social and not as scared of being on the unit. Maybe it was because I am more social than I thought, or perhaps it's because I was just bored, but I tried to engage with other people who were capable enough to have a conversation. Some of the other patients were lower functioning - delusional, suffering from dementia, severely withdrawn - but there were other people just like me who were there because their depression had compromised their fundamental safety. Most of the fellow patients I spoke with were kind and supportive.
During group therapy, after a lot of people requested discussing ECT (electroconvulsive therapy) and I started the patient-led discussion by asking someone to explain it. That started a great conversation about ECT which was very informative for me. (My takeaway was that I should never get it).
Dr. A and her posse of med students came to visit me during the downtime between group therapy and dinner. They asked me the same questions as the day before, and this time I felt more prepared. I was also ready to start pleading my case of why I should be allowed to go home. If I am going to keep on living at least let me go back into the real world so that I can enjoy the few things that had been my moments of zen. I had a concert to play in. I had theater tickets. I wanted to pick my son up from school. The suicidal ideation was still background noise, but I had come to realize during my two days of serious reflection that through death I gained nothing. At least if I stayed alive, I would have the fleeting moments of happiness and perhaps those brief moments would evolve into lasting happiness.
They offered me the option to go home the next day if I felt safe enough to do so. They had spoken with my outpatient therapist, psychiatrist, and my spouse and agreed that getting me home sooner was a better option. I was being released into a supportive environment with a stellar treatment team. They would set me up with intensive therapy for a few weeks, and although Dr. B still was skeptical, Dr. A looked at me and said, “Although we would normally keep a case like yours longer, I don’t think it’s necessary. I don’t think you’ll be back.”
I hope I will not be back either.
In 2008, Congress named July National Minority Mental Health Awareness Month. The purpose of this month is to bring awareness to issues surrounding mental health in minority communities where, due to reasons ranging from stigma to finances, mental health treatment is sorely lacking.
Here are some mind-boggling statistics on the state of mental health in ethnic minority communities:
So what can we do about this situation? How can we increase the awareness within minority communities regarding mental health? First, we need to recognize that mental illness does not give a shit what your background is. One out of five people is affected by some kind of mental illness; meaning anyone is susceptible. Pretending otherwise is foolhardy.
Secondly, no matter who you are or what your background is, if you or someone you love is struggling with mental health problems, encourage them to seek help either by finding a therapist or looking for different mental health resources. Do not assume they can just “snap out of it”. Fighting this battle alone is not an option. Help is available, regardless of your ethnicity.
(Continued from Part One)
At 6:45 a.m. someone came by to take my blood pressure. This wasn’t how I envisioned waking up that morning, but I also did not envision being a patient in the acute psychiatric ward (or “the unit” as its patients and staff called it). After the initial shock of remembering where I was and why this nurse aide had taken my vitals at dawn, I tried going back to sleep, but couldn’t. Instead, I laid in bed thinking about everything and nothing: “Will my husband be able to get my son to school on time?” “Should I call my parents?” “Am I still actively suicidal?” It’s easy to ruminate when you have nothing to do and only have the clothes on your back.
My day nurse came by around 8 a.m. to give me my schedule for the day. The agenda included meal times and the recommended activities for the day. She was very friendly, and despite my complete antipathy toward her (and anyone else involved in this current state of events), I couldn’t lash out at her. I simply nodded and answered her questions. I even asked questions about the schedule. After she left the room, I went to the nearest lounge and called home.
I talked to my son while my husband was driving him to school on time. After hearing his voice, I begrudgingly walked to the cafeteria to try eating. The disgusting meal I was served in ER and the bland snack I received at the unit the night before were the only things I had eaten in the last 48 hours. So I was hoping that breakfast would be better. Sadly, it wasn’t. I’m not a food snob, but I have certain standards when it comes to scrambled eggs, which were not met - they should at least taste like eggs for starters. I ate alone in a corner observing the other people who were locked up in the unit with me. There were no actively “crazy” people. I noticed some young adults, talking with each other as if they had been friends forever, a smattering of people looking stern and muttering to themselves, and people who looked and acted “sane”, just like me. We had all been deemed “a danger to ourselves or others”, but based on the atmosphere in that room, you would think we were just in some office cafeteria. This one, however, happened to have nurses wandering about with medication carts.
At 9 a.m. there was a morning check-in, similar to a school homeroom, with a nurse and a small group of other patients. During morning check-in, there was a skills-based therapy topic introduced, and it was also a chance for nurses to check in with their patients for the day. Morning check-ins are technically required, but like everything else on the unit, if you don’t show up, no one will force you to attend. I attended just to see what it was about and also because I was bored with waiting.
I did a lot of waiting around that first morning. I had told my nurse that I wouldn’t be attending any group activities until I had a real toothbrush and some fresh clothes. My husband was bringing me a bag packed with clothes, books, toiletries, and the most important thing: my watch. There were no clocks in my room, and I had no idea what time it was or how much time had passed. While waiting for my stuff, I was also waiting for the doctors. I wanted to put in my request for discharge immediately. I also wanted to argue that I’ll be fine and that I’d be better off not stuck on the 13th floor of a hospital.
My stuff came first. The staff had to search everything for contraband and things that can be used to harm yourself or others. They thoroughly searched my things, and the list of banned items is quite long. I understood they took my pants with drawstrings and shoes with shoelaces, but they also took away my electric toothbrush (to change out brush heads, you expose a pointy metal tip). Also, instead of giving me my original luggage sans the prohibited items, they put everything in paper bags, which they handed to me to take back to my room. As I was returning to my room, I saw a staff member was putting my nametag on my door. That was not a good sign.
I unpacked and changed my clothes. I had been studying for the CFA at the time and was working through questions on corporate finance when the knock came. The attending physician, her resident, and two medical students entered my room and tried to make themselves comfortable despite the limited seating. They proceeded to ask me how I was doing and a lot of other questions similar to those which I’d answered the previous day at the emergency evaluation. I answered everything more stoically than the previous day, knowing that I was being evaluated for weakness. They then asked if I had any suicidal thoughts and I admitted that I had been thinking about it, but more in the context of that being the catalyst for my admission. Subsequently, the attending, Dr. A, recommended that the dose of one of my medications be adjusted, and the team would check in with me again the next day. No one had an answer to when I would be discharged nor an answer about what criteria I’d need to meet to be discharged. I agreed to the medication change (I would have agreed to a lot of things if it meant I would get out sooner) and they left. I went back to the lounge and called home for the third time that day.
Afterward, I decided to give lunch a try. The lunch staff provided every patient with a menu to fill out in the morning for the following day. Since I had just been admitted, I hadn’t made my food choices yet, so I just ate whatever they had brought up. Lunch was not as bad as breakfast, but I was definitely missing my kitchen and Whole Foods. For this meal, I was joined by a patient who was delusional. He would wear a blazer over a hospital gown and wander around. Sometimes he’d also wear a pair of Ray-Bans. Although he was the classic example of who I expected to see in a place like this, he stood out quite a bit compared to most of the other patients. He told me how he just was woken up from a coma and saw Jesus. I did a lot of smiling and nodding as he talked because I did not know who was a “danger to others.” I did not want to find out the hard way.
The staff on the unit tried hard to keep people connected to the real world. The unit had three lounges with networked computers, free phones, and TVs. I mustered up all the courage I had and sent open and vulnerable messages to my friends. I told them I was in the unit, safe, and hoped to be back soon. I kept checking during the day to see whether anyone had responded. At this juncture, I was playing with a mental game with myself: if everyone ignored my messages, I could justify my fucked up perception that no one cared about me, but if everyone showed their support, then I had to accept that people cared for me. The outpouring of support was real and heartfelt and shattered my perception that my world was a cold and unfeeling place. I made phone calls to some friends just to hear their voices - just to know that there was still a world outside the unit.
After lunch, I attended my very first group therapy session. A day prior, if anyone had suggested that I go to group therapy, I would have considered punching them in the face. But with no other choices to pass the time, I decided to give it a try. This was a patient-led therapy, instead of facilitator-led, meaning the floor was open to whoever had something to share or talk about. I had skipped everything else leading up to the group therapy, including socializing with anyone except the Ray-Bans guy. So there I was sitting in a circle with other strangers who were all in the same situation as myself. The hospital was good about ensuring that the patients participating in my group were all high-functioning depressives with a grip on reality. At the end of their time in the unit, these patients would be discharged to their homes, rather than a long-term care facility.
After a minute of sitting in silence in this circle of strangers, I finally decided to ask a question: “How do you get used to being here?” The response came back fast and succinct: “You don’t.”
I “voluntarily” admitted myself into a really shitty sleepover camp.
Continued in Part 3
Here you are. You’ve arrived at the stage of contemplating mental health treatment. For me, this came after a weekend of being unable to do anything but lie in bed and cry. I finally realized my mood swings and suicidal thoughts were not healthy and I should seek help and support from a professional. Some of you may even be at the preparation phase of seeking out treatment. In this stage, you have to engage in the dreaded task of finding a provider.
When looking for a provider the three best sources to get referrals are:
Once you have your list, here are five pointers for choosing the best therapist based on my experience of being in and out of various therapies throughout the last 20 years.
Overall, the fact that you feel you need mental health treatment and you are seeking it is a big step. Furthermore, if you are having anxiety about making that first phone call, like I did, ask a friend or loved one to call around on your behalf. Do not get discouraged or give up when trying to find a provider you click with. Also, always remember that you can vote with your feet. If you are working with a provider who is not a good fit, just find a new one. You are the customer, and you deserve to find someone suitable to help you get well.