Leading up to the Psych Ward

When I finally got into a psychiatrist, one of the first things he told me was that he wanted me to spend some time in a Psychiatric hospital.

A thousand thoughts started running through my mind at once.  Was I going to have to quit my job?  How long would I have to stay?  Did I have to sleep there?  Was I allowed to leave?  Why did I have to go there?  Was I crazy?!

I started thinking to myself, “no, I’m not crazy,” and before I even finished the thought, I remembered that “crazy people don’t think they’re crazy.”  That worried me even more.  I was fully aware that I had already begun to lose touch with reality for short periods of time, but I was terrified that I was even further gone than I’d realized.

“It’s the best way to get a clear diagnosis,” he told me.  He assured me that I was still psychologically stable enough to make my own choices, and he therefore couldn’t force me into anything I didn’t want to do.  He couldn’t admit me to the hospital against my will.

My next thought was, “okay great, so I won’t go.”

He wasn’t about to give up that easily, though.  He listed reason after reason why it was a good idea for me to go.  And eventually, I agreed – not without reluctance, however.  This all took place on a Thursday afternoon, and my bed at the hospital was reserved for the following Monday.  I was to stay two weeks.

I left my appointment that day feeling like I had failed myself.  I never imagined that anyone would think it necessary for me to stay in the psych ward.  I had never pictured myself in the situation I was now finding myself in, and I didn’t like the way it felt.  I called up Nick and I cried on the phone to him, telling him everything that had just transpired.  As always, he was supportive however he knew how to be, and assured me that the doctors knew the best route to take.

That didn’t ease my mind.  Although I knew that at this point my visit was voluntary, I managed to convince myself that they’d find something seriously wrong with me and I’d never be let out.  I was going to spend the rest of my life locked up in the loony bin.

Hello, anxiety.  Hello, paranoia.  Hello, delusional thinking.

My mind was a roller coaster.  My thoughts were strapped in, looping around and around, up and down, shaking me up as they went.

By the next day, I was in a full-blown depression.  I was dreading the trip to the hospital, and I couldn’t focus on anything else.  I came home from work that Friday evening and decided to go for a walk to try and clear my mind.  I didn’t take anything with me – not my phone, not my keys, not even a jacket.  It was just me and my crazy roller coaster mind.

I don’t know how long I was gone.  I wandered aimlessly for hours.  I stood on the bridge overlooking the river, then walked down, staring at the water for far too long.  I must have faded away from myself for a while, because the next thing I knew, I was sat at the train station near my house, just watching the trains go by.  I was sat at the end of the tracks – I always did that, because if I ever got the courage to jump, I wanted to be close enough to do it before I changed my mind.

Thankfully I never got the courage.

I don’t remember much from that night.  I remember being at the subway station, and then I remember standing outside my apartment building, reaching up to ring my own bell.  I was buzzed in, and I slowly climbed up the stairs.  Nick was running down them, panic-stricken, asking me where I had been, what I had been doing, what I had taken.

“Out.  I don’t know.  Nothing.”  Zombie-toned responses, expressionless face.

Although I was completely out of it, I hadn’t actually taken anything that night.  There was an open bottle of ibuprofen on the counter, and Nick thought I had gotten into it.  I hadn’t.  I had learned by that stage, through trial and error, that ibuprofen was just not going to get the job done.

Nick brought me inside, questioned me some more, and told me he had been so worried that he had been asking everyone if they had heard from me – he even had people on their way over to help look for me.

I was mad.  Furious. How many times had I told him not to tell people things about me?

I went into the bedroom, and Nick retreated back to the kitchen.  His senses were always on high when I was in a state, so it’s no wonder he heard me opening up the window, and was back in the room with me before I managed to climb up into it.  He stopped me well before I even attempted jumping.

I stormed out of the bedroom, probably en route to the kitchen for a knife, and I screamed bloody murder when I saw a friend in our living room.  He had just come in – he was already on his way over when I stumbled home.  I wasn’t expecting anyone to be there with us, and it shocked me so badly that I was sent into a sort of panic attack.  It also sent my anger over the edge, and I was instantly determined to do something, I just didn’t know what.

I can’t begin to describe the thoughts that were going through my mind at this stage, because I sincerely do not remember.  I can’t put myself back into that moment of time, because I wasn’t there with myself.  That person was not me.

I closed the bedroom door, claiming I wanted to just be alone, and when I thought no one was listening, I opened up the window again.  I climbed into the window sill, stood on the ledge, looking down four stories, as the bedroom door swung open behind me.  Nick bolted in, got me down from the window, and begged me to stay away from it.

He told me the bedroom door had to stay open now – I had proved to him that I couldn’t be trusted.

He said he’d leave me alone, but he’d be in the next room, with plain-sight view of the two windows.

I told Nick that I wanted the friend gone.  He said okay.  He left the room, I heard the door, and that was that.  I calmed down.  I got into bed.

I was just coming back into myself when I saw two men walk into my bedroom.  I didn’t know them.

I sat straight up, bewildered, and they spoke to me, in German, asking if I was okay.

Paramedics.

I told them I was fine now.  I knew I had to admit what had happened, because I was sure they already knew.  I told them I had had a bad moment – that yes, I had attempted to jump from the window, but I wouldn’t do it again; that I was calm now; that I was okay.

They stayed there and spoke to me for a while, suggesting they bring me to a hospital in Nussbaumstrasse – the very hospital that had a bed with my name on it reserved for two days later.  I told them I was going there on Monday, and that I would be okay at home until then.

All they had me do was promise them that I wouldn’t hurt myself.  I promised.  I could have easily been lying.

Advertisements

What the f#$% is schizo-affective disorder?

Schizo-affective disorder and I have gotten to know each other pretty well in the recent years, but not many other people know what it is.

I remember when I first heard of it. My GP and I were sat in his office. We were discussing my downfall, and finally working on a referral to a psychiatrist. He needed to give them a preliminary diagnosis. He heard me out – he listened to my symptoms, looked back on notes from previous visits. He told me not to flinch at the words, and then he said them: “Sounds like schizo-affective disorder. I can’t diagnose and treat you for it, so we need to scare the psychiatrist into seeing you as soon as possible.”

Apparently schizo-affective disorder was enough to push me to the front of the line. I had an appointment within two days.

It sounded so intimidating. The ‘schizo’ part just screams out ‘you’re crazy!’ I didn’t know what to think of it. Mainly because I didn’t really know what it was. There isn’t exactly a way to describe it clearly. In fact, it’s not very well understood at all – not even by the doctors – which is why it took so long for me to be properly diagnosed.

Schizo-affective disorder, at the end of the day, is a mix-match of schizophrenia and bi-polar disorder. It’s a hybrid of two very well-known mental illnesses, but it means something different for everyone with the diagnosis.

Some people with schizo-affective disorder may only have very mild schizophrenic symptoms. Some may have very severe ones. Some may have seemingly none at all.

Schizo-affective disorder can disguise itself unintentionally. Since it embodies characteristics of other better-known, more common disorders, it can be extremely difficult to recognize.

So difficult, in fact, that it took over a year for my doctors to finally agree that I might indeed have the disorder.

The problem with diagnosing a mental illness is that there is usually nothing physical to examine. Doctors rely greatly on a patient’s own description of their symptoms. The problem with this is that many people suffering from mental illness are unable to articulate what’s happening in their mind, and therefore can’t always provide the information the psychiatrist needs. I was no different.

My doctor asked me if I had any close friends who would volunteer their time to speak with him.

About me.

That made me feel uneasy. One of my main concerns was people talking about me. It’s the last thing I wanted. At first I refused. I used the excuse that no one knew what was in my mind anyway, so they’d be useless. He assured me my behavior was just as important as my thoughts.

Nick came with me to my next appointment.

We sat there all together, the three of us. I remember feeling really nervous. I never knew what to say at these appointments. What was I supposed to tell the doctor? He’d ask me how I felt, I’d say I felt bad. He’d ask me why, I’d say I didn’t know. Isn’t that why I was there in the first place? Because I didn’t know? Surely, if I knew why I felt so horrible, I would do something about it that didn’t involve sitting in an uncomfortable office.

I started to cry. He asked me why I was crying. I didn’t really know why – I just felt overwhelmed. He told me to relax, Nick told me to relax; everything was fine. They started to talk about my moods, my behaviour, my sleeping patterns. I don’t remember any specifics. I was in the room but I was in another zone.

He talked with Nick for a while, then he talked with me for a while, and then Nick and I went home… with another few surveys to fill out.

Eventually, many appointments and surveys later, my psychiatrist came up with a final diagnosis: schizo-affective disorder. Surprise, surprise, my GP had been right all along!

In order to decide which medications to use, we had to really discuss my symptoms in depth. As with any mental illness, schizo-affective disorder needs to be treated differently depending on how it is manifesting itself in the patient. There is no magic medicine designed specifically to fix up a person suffering from the disorder.

For example: schizophrenic symptoms come in many forms. Auditory hallucinations, visual hallucinations, paranoia, delusions, disorganised thought and speech. The list goes on.

The affective (mood) symptoms also vary greatly. Some patients might suffer only slightly – others, nearly exclusively – from mania. One person’s manic symptoms may differ from another person’s. Some people may experience depressive episodes more strongly. Some, like me, may have a nice mix of the two.

For me, the ‘affective’ aspect of the disorder was always quite clear. That’s probably why I was misdiagnosed as having bipolar disorder. I had week- or month-long episodes of depression, followed by episodes of mania lasting a similar amount of time. This had already been going on for years.

My schizophrenic symptoms, however, were harder to pinpoint.

I had hallucinations, but I was always able to recognise that they were simply that: hallucinations. Typically, they’d be visual (but I did have auditory ones as well): I’d see a person out of the corner of my eye. If I kept them in my peripheral vision, they were very much there, but as soon as I’d turn to them, they’d disappear. This is how I was able to distinguish between real people and fabrications of my mind. Since I was aware I was hallucinating in the moment, my psychiatrist figured it didn’t really count, and more or less dismissed the hallucinations entirely.

One symptom he definitely focused on was my delusional thinking; I would create wild stories in my mind and believe them. I was convinced everyone in the subway was staring at me and talking about me. I thought people were watching me all the time. At one point, I genuinely believed Nick was an alien. He has a vein in his forehead that sometimes buldges out, and my mind came up with an explanation for it: he’s an alien, obviously.

Despite having these crazy thoughts on a regular basis, I would also have spouts of clarity where I realised how ridiculous I was being. Did I really think that Nick was from another planet? At some moments, yes; at others, no, of course not. I was always sane enough to hold back from sharing my ideas with people, because I didn’t want them to get the wrong impression and think I was a whack job. I definitely did have some crazy thoughts, but the crazy never took over my mind for too long.

I always snapped out of it.

But the reality of the situation was that, although I wasn’t suffering 100% of the time, I was still suffering. I was still delusional and paranoid. Although I could distinguish between hallucinations and reality, the hallucinations were still very distracting. These things were having a big impact on my every day life, and something needed to be done about it.

So, we started to experiment. We stuck with the quetiapine, a drug I had been on for months to help me sleep, and tried a few different medications before we reached a cocktail that was suitable. Finally the tunnel was getting a little brighter.

My treatment doesn’t rid me completely of the effects of my disorder; I still suffer from all things listed above – just on a much, much milder level. I can live like a regular person 75% of the time, but I still have days where I can’t get out of bed.

Schizo-affective disorder is probably going to affect me for the rest of my life but, it isn’t going to dictate my life. That’s my job. I’m still in charge here.