Tag: Psychiatric Hospital Admission

Gentle Shoots Of Hope

I entered this year softly. Sparkling into it from one minute to the next, without expectation. But finding joy on the other side of the second hand.

I could now spend a paragraph on the 2020/2021 disclaimer for happiness, the guilty acknowledgement of everyone who may be suffering, that feels as though it has become mandatory whenever you write or talk about anything remotely good happening to you in pandemic times.

But I won’t, because in this moment it feels disingenuous. The events of the last couple of years may have thrown it into sharper relief, but virus or not there have always been people who have it worse than me and those who have it better.

So – no disclaimers. We’ve all had challenges from the dung heap of life thrown at us. I don’t believe bad things happen for a reason. But I do believe that it is the rubbish times that make magic moments shine when we happen upon them.

I spent New Year’s Eve last year (2020/2021) in hospital – just one day in a holiday package that started with an admission on Boxing Day. I didn’t feel well enough for people. Including my husband and children. Dinner came with a serve of ‘seasonal vegetables’ leached of colour and boiled into malodourous oblivion. Dessert was my nightly mouthful of dry medications washed down with tepid water. Long before midnight I was obliterated by that medication and happy to be so. Joy was not part of the equation.

When it came to thinking about New Year’s Eve plans for last year, I had only recently discharged from hospital after another Bipolar flare. A brief 3 week admission starting in late October that bled well into November.

I juggled the idea of having friends join us for what is a special evening for me.

From the ages of six to thirteen I grew up in Germany, in a culture that celebrates New Year’s Eve joyfully and raucously. I remember towers of champagne glasses filled and overflowing with bubbles from the top tier down. There was music and animated conversation, which gave way to the fireworks at midnight. People bought their fireworks from the supermarket and let them rip into the newborn year from their snowy backyards.

On New Year’s Eve 2000 I introduced my (then new) husband Michael to this way of celebrating. We were living in the UK, but had travelled back to Germany for the holidays. We spent that New Year’s Eve with Sandra, one of my closest friends, and Thomas – her partner, and their friends. We had raclette, lots of drinks, and laughed so hard. Just before midnight, we climbed into our coats, boots, hats, scarves, and gloves and walked, stumbling ever so slightly, down to the beautiful lake Sandra and I had spent childhood summers swimming in and childhood winters ice skating on. It was freezing. Too cold to feel our faces. The whole village was there. The air smelt of nothing but fireworks. We were in our twenties and euphoric.

Thomas died barely six weeks ago. The loss of someone we loved has been compounded for me because I can’t hug his wife – my lifelong friend whose hand I used to hold as we jumped into a New Year.

New Year’s Eve in Australia is different. It is the hot afterthought to a showy Christmas. The vibe around New Years for many Australians is ‘Meh – can’t be bothered.’ or it’s a night of heavy drinking that culminates in a headache on New Year’s morning and a set of resolutions, which won’t last past January.

And yet I celebrate the ending and beginning of years…when I can. In part it is fuelled by nostalgia. It is also because I have learnt to celebrate things while I can, because there will be times when I have no choice whether I get to celebrate or not. There are times when I am too unwell. Times when it’s overboiled vegetables instead of home cooking.

Not celebrating can also be a missed opportunity for making memories. Memories of joyous hours, which become part of everyone’s narrative. Memories that become unspeakably precious in hindsight when we have lost those we shared them with.

And so, I sent out some invitations and had a beautiful night.

There were candles and sparklers and laughter across an increasingly messy tablecloth as the night moved on. We ate pistachio baclava with mint and rosewater syrup and white peach sorbet for dessert.

By 2 am the house was buzzing. I had picked up my older child and two of their friends from another party to join the other couple of kids already at home for a sleepover. In the early hours of this New Year my house was steeped in happiness.

For me, 2022 has started with love and energy, and out of the losses and difficulties of the previous year I sense gentle shoots of hope are emerging.

One of the positives of 2021 was that my memoir Abductions From My Beautiful Life was published. For an excerpt and more info click here Book

You may like to check out how some of my other years have gone in these posts:

2020 Ends In Hospital

Covid Lockdown In A Psychiatric Hospital

2018 – The Year I:

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

You may also like to read:

When Covid-19 And Bipolar Recovery Collide With Unexpected Results

From Holiday To Hospital In Under A Month

Psychiatric Medication And Stigma

From Holiday To Hospital In Under A Month

The place from where my words usually come is wrapped in wet cotton wool. I am in hospital.

For years now my prodromal signs of loss of concentration and short term memory – which can be precursors to either a manic/psychotic episode or a depressive episode – have always landed on the manic/psychotic side.

This time the signs were the same. My psychiatrist and I gambled, counted on the past history of manic psychotic, adjusted medication accordingly.

Only it went the other way. I flattened, unhelpful phrases trudged like a battalion of soldiers through my soggy brain: …better off without you…. Everyone. 

There is no need for alarmed raising of eyebrows. This is not my first go on this merry-go-round.

Those derogatory words and phrases are completely alien to me. I can see them for what they are. Just a clinical sign. Nothing more, nothing less. They don’t prompt me to hatch self destructive plans. They prompt me towards my psychiatrist, and towards hospital, because the world feels like sandpaper on my soft brain. The hospital won’t fix it quick, but it will bandage the raw areas while they heal.

At this level I find depressive symptoms are easier to manage, easier to live with than manic symptoms…unless of course I plummet to the complete paralysis of catatonic depression…and then it’s just as horrid, possibly worse.

I may expand on this comparison of symptoms  in the future. For now there is no concentration, and motivation feels like riding a slug to catch up with a leopard made of quicksilver. There is literally no point.

I do own a new hospital mug. The design is fresh, green, paisley, floral… It is sprightly. It’s the  small things that make it less bad.

2020 Ends In Hospital

Insight: The Essential Ingredient

Visiting Someone In A Psychiatric Hospital?

Covid Lockdown In A Psychiatric Hospital

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.

You may also like to check out:

2020 Ends In Hospital

Visiting Someone In A Psychiatric Hospital?

On Uncertainty

2020 Ends In Hospital

I am going into hospital later today.

And I am aching to get there, straining towards the moment I close the door to my hospital room on a world I am the wrong shape for right now.

How did I get here this time?

Fourteen days ago I had a regular appointment with my psychiatrist. Just a Bipolar 1 Disorder monthly maintenance appointment. I was completely asymptomatic.

Thirteen days ago I left for our beach holiday and forgot to pack my swim wear. Subtle. I mean that could happen to anyone. Right? But by the following morning I was symptomatic alright. My short term memory and concentration were dissolving like sugar cubes in boiling water.

A buzzing pressure behind my eyes radiated up my forehead. I knew from bitter experience, if I did nothing, soon that buzzing could make me second guess what was real or not.

That was symptomatic enough to page my psychiatrist on a Saturday morning. It’s only the second time I’ve paged him out of hours in 14 years. He called back in under three minutes.

Over the last nearly two weeks, the first of which I stayed at the beach, he telephone consulted with me every second day, adjusting medications, a little more of this, a little more often of that. I slipped from my bed gratefully into the ocean, timing the most sedating medications for times when I’d be in bed not the ocean. I seemed a little better, maybe? But then not.

Back home we continued every second day phone consults, adjustments. This is by far not the sickest I have ever been (although psychosis and catatonic depression requiring ECT to reverse, do set a very low bar)

So why would I want to go into hospital, rather than continue treatment at home?

Here’s why:

The surface of my brain feels as though it is covered in papercuts and being surrounded by people and noise is like having lemon juice dribbled over the cuts.

Trying to hold in the irritability of being around people and noise (including my close family) is like being intensely nauseous with someone threatening to punish you if you vomit.

One of the parameters I use to assess how close I am to needing to go into hospital is ‘the sandwich test’. Think about the amount of concentration and short term memory it takes to make a sandwich – nothing fancy, just two slices of bread, some butter and one topping. For most healthy, able bodied, able brained adults, this is not a challenging task.

Right now – I can still make a sandwich, but it’s a challenge. I am making a decision, based on past experiences, not to wait with hospitalisation until challenge becomes an impossibility.

As for the seasonal timing – Christmas and New Years celebrations? I am veteran enough in the management of this illness to know it has no knowledge of nor respect for holidays and anniversaries. I could list my tenth and fifteenth wedding anniversaries as times spent in hospital, a longed for trip to Paris cancelled because of recent hospitalisation, and that would be the beginning of a list so long I’ve forgotten most of it. These times are just human constructs. If it swallows them I don’t dwell on them.

Instead I celebrate the unscathed special occasions extra hard, to make up for the times there is nothing.

The final reason for going into hospital now, is because I can access this level of care. I am fortunate to have the option of going into a private psychiatric hospital when I am sick. The standard of hospital care I will receive will be excellent. It will far exceed anything the public psychiatric hospital system has to offer.

I loathe getting sick enough to need hospital support. But perhaps even more than this I loathe the hypocrisy of someone with my privilege not utilising that support because of some misguided stigmatising ideas about what it means to be a patient in a psychiatric hospital.

I am profoundly grateful I can afford care in a good private psychiatric hospital. And part of my own recovery, once I’ve stabilised medically, is to remember there are many people living with this illness, and other severe mental illnesses, who are learning to live with them with far less support and privilege than I have. When my recovery feels hard I focus on this:

If I access the supports I am fortunate to have, I am more likely to be around for long enough to help raise awareness of the inequality between our private and public mental health hospital systems, and work towards our public mental health hospital system actually supporting some of our most vulnerable when they need it most.

If you are new to Thought Food and would like to know a little bit about who I am when I am well, you may like to check out:

Who Am I ?

Radio And Podcast Interviews

On Uncertainty

Written for QLD Mental Health Week 2020

How does uncertainty make you feel?

I ask because uncertainty is having a moment right now. It galloped in with the Covid-19 pandemic, and the further we get into it the more it seems to be digging itself into our awareness.

I used to be deeply uncomfortable with the pebble of uncertainty in the shoe of my life. I liked to know what was ahead. It gave me a (false) sense of control and the misguided belief that just because I couldn’t see uncertainty in my life, it didn’t exist. I deluded myself for decades that when there were no clouds on the horizon, the course of my life was somehow more certain than if I could see trouble ahead.

Then all the certainty in my life was put through a paper shredder within five days of my first baby’s birth.

I got my new baby experience with a side of florid postnatal psychosis severe enough to warrant admission to the locked Special Care Unit of a psychiatric hospital. My sense of certainty and control over my life went down the toilet.

After I’d recovered from this psychotic episode I felt entitled to some certainty. I wanted to know this nightmare was over. And I wanted a guarantee it would never happen again.

So when my psychiatrist mentioned ‘a possible underlying Bipolar Disorder’ and that it would ‘take three to five years to know for sure’, the inside of my head threw a combination of a tantrum and a pity party.

When I got sick again after three years, after seven years, and after nine years and my diagnosis of Bipolar 1 Disorder was confirmed, I still felt entitled. Entitled because: ‘hadn’t I suffered enough yet?’ Entitled to not have to tiptoe through my life with everything clenched, waiting for the next time this thing pounced.

I have only recently acquired some degree of acceptance of the uncertainty this illness introduced into my life. I didn’t enjoy the last two episodes in 2018 and early 2020, but I also didn’t waste energy resisting them. In the same way I no longer spend any of my resources anxiously wondering when it will happen next and how bad it will be, because without wanting to sound nauseatingly Zen, the truth is: It will be what it will be when it will be.

Uncertainty exists in everyone’s life every day. But instead of it floating along in the background, right now it is constantly being rammed down our throats. It’s like having a nasty little gremlin on your shoulder whispering over and over again:

‘You do realise bad things could happen to you at any minute’, when the true risk of something bad happening to you is probably not that different to pre-Covid times.

For our mental health to survive this pandemic we have to learn to live with uncertainty, because the end of it is nowhere in sight. And just like my psychiatrist couldn’t give me any certainty when I first got sick, the smartest scientists in the world aren’t able to accurately answer this question about Covid-19: Will it ever be over, and if so when?

Uncertainty is an uninvited, kicking, snoring bedfellow. So how do we get comfortable with it?

First we tease out what about this situation we can control and what we can’t. For example, we can’t control the flow of information that feeds our uncertainties rushing over us every day, but we can control how much of it we absorb.

And once we’ve done what is in our control to help ourselves, we have to try and unclench from the need to know what is going to happen next. We need to stop trying to know and plan for a future that is like a spiderweb in a storm. Here’s what I mean:

During one of my admissions to hospital I sat staring out of the window of my room feeling as though there was no point in doing the work to rebuild myself because my future was too uncertain, my illness could tear me apart again anytime.

Over a couple of days of intermittent staring I noticed a spider in its web just outside my window. Every night it stormed. Rain, wind, a couple of times hail tore chunks out of the web, at times almost destroying it.

That spider showed me the way out of my tangled thoughts, by not only rebuilding every time after its pristine web was wrecked, but doing so in the face of the risk of the same thing happening again, whether the next day or in a year.

The sword of an uncertain future has hung over every single one of us since the day we were born. Nothing has changed there. It is just up to us whether we choose to battle with uncertainty and lose, or whether we accept that being alive will always mean living with uncertainty, pandemic or no pandemic.

You may also like to check out:

Lessons For A Control Freak

The Other Curve Being Flattened

When Covid-19 And Bipolar Recovery Collide With Unexpected Results

Tokenism In Mental Health Awareness

Mental Illness Doesn’t Respect Deadlines

20190729_064126
September 2001 – Ascending the Col du Tourmalet

‘How long until I’m better?’ gnaws at my insides.

When I ask my psychiatrist that question, he always answers honestly:

‘I don’t know how long, but you will get you better.’

That ‘I don’t know’ even when it’s followed by a promise of eventual wellness, is brutal.

Many years ago, my husband and I took part in a cycling trip over the Pyrenees from the south of France into Spain. The route followed the same path as the Tour de France sometimes does. The first day took us up the Col du Tourmalet, one of the longest and steepest climbs. We rode around twenty kilometres to the base of the mountain and then climbed for close to another twenty, each one steeper than the last, the air getting thinner and thinner.

The last two kilometres were gruelling. Mist closed in. We could barely see the drop off the edge of the mountain. We rode on our lowest gears. Our bones turned into burning jelly and our lungs felt as though they were trying to extract oxygen from water. We were forced to stop to catch our breath every twenty or thirty metres.

But there were markers to show us we were getting closer to the top. Mental footholds in the misty, painful, breathless soup. We had answers to ‘How much longer?’. And with them came hope and the tenacity to keep going. Although it was unbelievably challenging, we had an end point to work towards.

Continue reading “Mental Illness Doesn’t Respect Deadlines”

Search Warrants

InkedAdmission details_LI.jpgWhat would you pack for a stay in a psychiatric hospital?

Think first about what you will need in the first half hour after you arrive. You don’t actually pack these, but if it’s your first time they’re worth knowing about.

Here’s what I aim to bring to get me through the admission process:

My dignity and a fullish bladder.

Continue reading “Search Warrants”

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