Tag: Isolation

Invisible Damage

9.30 pm at the medication station.

I confirm my name and date of birth. A nurse hands me a tiny paper cup. It rattles slightly, this mix of yellow, white, and orange lolly shapes.

‘See if that looks right.’

I never go on looks alone. I recite the contents of the 13 tablets back to the nurse, as though I were the one prescribing and dispensing:

‘750mg Lithium, 50mg agomelatine, 100mg quetiapine XR, 150 mg regular quetiapine, 1mg clonazepam, and 10mg of temazepam (prn)’.

Just before I swallow them, my mouth feels full of loose teeth.

And then I drift down a dimly lit blue carpeted corridor that ends in an opaque glass window covered in giant blown dandelions, until I am back in my room.

I feel so removed from my life I may as well be orbiting it in a spaceship.

I feel the anxious tug deep in my belly, knowing the longer I orbit, the longer and harder my earthling reintegration will be.

Outside of these corridors, this mission to heal my brain, my family pushes and pulls itself into an unnatural, temporary shape. Each member forced to stretch and thin out to cover the hole of my absence.

My family hurts in ways I can barely imagine, while the hurt in my brain lands me in this other world.

It feels as though my family is the only family to contort itself for as long and as often as mine does every time I get sick. It doesn’t matter that they are all resilient and used to it. It doesn’t matter that we manage it as well as anyone possibly could.

I don’t want my illness infiltrating my children’s’ growing years. But it does. Each time a little more.

This frustration doesn’t negate my gratitude for having access to a hospital that allows me whatever time it takes to treat acute episodes of this illness. But at the same time my gratitude sometimes feels like petrol when I attempt to douse the flames of frustration with it.

I know people feel relieved when I announce I am coming home. I don’t share their relief because it is not an easy slotting back into place. It is tearing my way back into a family that has been forced to operate without me. It is blinding and muting myself to all the tiny little things …and the bigger ones that they have had to do differently to survive the lack of me.

And yet, I know that my absence from my family is less damaging to them than my symptomatic presence would be, when I am barely safe in my own company. My distress at having no memory or concentration, at being loaded like a gun with pathological irritability, losing touch with reality – these are not things I want to subject my husband or children to.  It would shred us into irreparable pieces. So, I choose the lesser of the damages.

Even as I hate to think about the scar tissue left behind, I know I can repair the stretching, thinning induced by my absence, given time.

That time starts at discharge.

I will be home to begin work to repair while I work to reintegrate…possibly within days.

PS: The list of medications included in this piece is a snapshot of one evenings’ medications for me in hospital. It should never be used as a comparison to anyone else’s medication. Psychiatric medication regimes are highly individualised and often change over time. A medication combination that works well for one person can be a disaster for someone else, even if they share a diagnosis. Always consult a psychiatrist before taking any psychiatric medications. If that’s not an option, then a GP

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Covid Lockdown In A Psychiatric Hospital

I recently encountered Covid  restrictions and a lockdown as an inpatient in a psychiatric hospital. And while the specifics are relevant, my experience was more complex than donning a mask and staying inside. But let’s start with the specifics.

There is the loss of the hospital dining room and its well-stocked salad bar. This normally bright spacious room filled with chatter and choice has closed, gone into mourning. The ability to choose your own food and sit where you liked – a small token of independence – replaced by a tray delivered to your room at 7am, 12 pm, and 5pm with a sharp rap at the door. You get little choice and a small window to eat before the kitchen staff are back to collect your tray.

There is not being able to leave the hospital grounds until discharge. No opportunity to test where you are at with a short visit home. Another small freedom lost, and you become totally reliant on visitors to bring you anything you might need from the outside world. Until restrictions turn to lockdown and the visitors are banned from visiting.

All staff start wearing masks, and the buzz of their anxiety fills the hallways like a swarm of bees. Within a few days patients are told to wear masks anytime they are outside their rooms.

For anyone who has lived on this planet for the last year, none of these restrictions or lockdown conditions will sound unusual. Everyone has lived some version of them.

But my experience of them as a psychiatric hospital inpatient was different to my experience of them when I’ve been well and at home.

Here’s why:

Even with access to an excellent private psychiatric hospital, being an inpatient strips me of autonomy and leaves me feeling as vulnerable as a slug on a busy highway.

The admission process alone – which includes providing a urine sample for drug testing and the thorough inspection of your bags (for any means of self-harm or suicide) by two gloved nurses – is a humiliating experience.

 It screams: ‘You cannot be trusted’ and whispers sharply: ‘We are in charge of you now.’

It’s made worse if the nurses attempt light conversation about the contents of my bag.

‘‘That looks like a good book…’

I don’t have the energy for it, and it makes me feel like a toddler they are trying to distract from something unpleasant.

As a patient in a psychiatric hospital I frequently lose the right to my feelings. For example:

One of my admitting symptoms (usually prodromal to mania) can be intense pathological irritability. It is completely different to feeling irritable in a normal context. And it is not the same as the irritability I feel when I am forced to interact with one of the nurses whose attitude grates on me even when I’m well.

 I try to be polite, but when my tone slides into curt, she cocks her head and says:

‘Your irritability levels are quite high today.’ before self-importantly noting this down as a symptom for the day. And I am powerless, because if I protest that would just be further proof of my mental illness to her.

And then there are the cringeworthy names I am called, mostly by nurses and kitchen staff:

‘Dear, Darling, Love.’

 I am ‘Darling’ to only my mother. ‘Love’ never fails to sound derogatory to me. As for ‘Dear’ – one of my worst and earliest hospital experiences involved being called ‘Dear’:

Fourteen and a half years ago when I was less than a week into my first episode of mental illness, I experienced a severe psychotic episode. I was led into the Special Care Unit (the highest security locked ward) of the psychiatric hospital by two nurses, one gripping each elbow.  On the way there, one of these nurses said:

‘Don’t worry Dear. You won’t remember any of this in the morning.’

The next morning I was so sedated by the (necessary) medication I‘d been given, I may not have looked as though I had any memory of the horrors of psychosis. But I remembered all of it. The proof is in the account of that night in my memoir being published this year.

If I knew where to find the nurse who called me ‘Dear’ (on that occasion), I would give her a copy to show her just how much a patient experiencing florid psychosis can remember.

There are many other factors that contribute to my sense of infantilisation in hospital. But elaborating on them would take me well over my word limit. So I’ll leave it here, for now.

Thankfully this recent admission was short (two and a half weeks) but the combination of the inherent lack of autonomy in being a psychiatric inpatient and the above mentioned  Covid factors hugely amplified my vulnerability.

And I have never felt so powerless.

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Reintegration: Be Careful Out There

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free image from Canva

This past week has not been pretty.

Aside from a call to the poisons information centre, three visits to the dentist, one to a paediatric physiotherapist, one to my psychologist, recalcitrance and poor behaviour from me and my children, it also included a near fatal accident.

I nearly killed a young man at the beginning of this week.

And I did not want to write about it. The shame and incomprehension of this close call burn me in waves. But this incident bore a loud message, which I did want to write about.

On the first day back of school after months of lock down, I hadn’t planned to drive my children to their schools. We are walking distance from both. But time does strange things on school mornings. It slithers away at warped speed and suddenly, the window to comfortably walk to school on time slams shut. So, I drove them, on the proviso that this was going to be an exception.

Driving conditions during isolation have been muted. The amount of traffic diminished to that of a tiny country town in the middle of the night. School traffic ceased. Work commuter numbers slashed.

On that first day back at school, cars converged on the local streets and clustered around the schools like flies on a carcass. Drivers were filled with more emotion than a regular school drop off warrants. Joy. Fear. Dread.

My feelings? Happiness over the end to at home learning mixed with mild irritation at not having managed to get both kids out the door on foot on time. And once I’d dropped them, an urgent need to get back home and away from the chaotic traffic.

Impatience bloomed. I decided to make a right turn from a side street onto the main road across two lanes of traffic, to get me home more quickly than a series of left turns would have. The car in front of me went during a break in traffic in the first lane and was let in by a driver in the second lane.

I could see the same driver in the second lane holding a space for me to cross. So, I went.

I don’t remember if I glanced to my right to check the first lane was still clear. But the moment I slammed on my brakes and a young man on a red motorcycle had to swerve to avoid me, is burnt into the pit of my stomach.

I am a careful driver. In over 25 years on the road I have never had a serious accident. I have never driven drunk or while under the influence of prescription medication or non prescription drugs. I don’t text and drive. I was not sleep deprived or sick that morning.

So why this serious error in judgement?

Distraction, yes.

But there was more to it. While we have been in isolation, our worlds shrunk to our homes and occasional short car trips on empty roads, it has almost been like a lengthy period of hospitalisation.

I know from all the times I have discharged from hospital after weeks inside that just because I am out of hospital, my life doesn’t just snap back into place. I have to put the pieces of it carefully back together.

Re-entry into the world after isolation is the same. Our reflexes are slower. We are more vulnerable to chaos.

I am not nostalgic for isolation time. I don’t want to regress into the woolliness of those early iso days, drifting down deserted streets, staring perplexed at empty toilet paper shelves surrounded by people with harried expressions behaving as though the world was ending.

I will be very happy to never again step into the uncomfortable ill-fitting role of someone attempting to assist with my children’s at home learning.

But the jolt of re-entry has been a wake up call. A wake up call that I need to take the time to consciously reintegrate after this most bizarre episode of ‘home hospitalisation’.  My brain and body need some adjustment time. My children’s brains and bodies need some adjustment time.

Perhaps the most poignant aspect of my near miss accident happened immediately afterwards. The young man on the motorbike pulled over and came up to my car. I wound down the window ready for, and feeling deserving of, his abuse and anger.

He didn’t abuse me or even swear.

He asked: ‘Did you not see me, because that was really close?’

All I could say was: ‘No, and I am so, so sorry. I am so sorry.’

I will never forget the young man’s face, his emotional intelligence and compassion in an adrenalin soaked moment. And I will never forget his parting words:

‘Be careful out there.’

We need to collectively ‘be careful out there’ as we re-integrate after isolation or we will misjudge situations and possibly make fatal errors.

Postscript:

The other lesson learnt the hard way by another member of the family this week (and one I doubt has anything to do with reintegration) was not to open a tube of superglue with your teeth.

 

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