A week in the psych ward

When my doctor told me I had to stay at the psychiatric hospital, I had to decide what to do about work.  I was working full time at a kindergarten.  Although the German health care system ensures you are paid for any work missed due to documented medical reasons, I wasn’t sure what to tell my employer.  Should I be honest, and risk ridicule or a change in people’s perception of me, or should I lie and say I was home with the flu, and have no one be the wiser?

At this stage, I was worried about that sort of thing.  I didn’t want anyone to see me as weak – I mean, after all, I was missing work for being ‘sad,’ wasn’t I?  Of course there is much more to it than that – but depressives don’t always give themselves enough credit.  And, let’s face it: unfortunately there is still a strong stigma, and not everyone is empathetic or understanding.

After much consideration, I ultimately decided to tell only one person at work the truth, and I told the rest I had bronchitis – that was believable because it happened to be going around the school at the time.  Apart from one colleague, everyone at work was left in the dark.  I preferred it that way.  They didn’t need to know.  My opinion on this matter – believe it or not – has not really changed.

So, along came that dreaded, long-awaited Monday morning.  Nick and I woke up, I threw some clothes and basic essentials in a bag, and we set off.  The hospital was only two subway stations away – I was about to be locked up a mere five minutes away from my comfort zone.  Somehow, that made everything worse – so close to home, yet so far from normalcy.  As we were sitting in the waiting room, organizing paperwork, I contemplated getting up and leaving – going back home to bed, pretending like nothing had happened.

We were sent upstairs, greeted by a nurse upon arrival.  I immediately didn’t like the place.  It was so cold and sterile.  There was no life in that building.  All doors were locked; a nurse and a key required for everything.  I was shown to my bed and Nick and I said our goodbyes. I knew I was going to see him later that night – he had promised to visit me – but despite that knowledge, I felt lonely and abandoned when he left. Everything was so foreign to me (in every possible way) and the thought of facing it all alone was not a happy one.

I was introduced to Evie – one of my three roommates, who happened to be ten times crazier than I was.  She was a very nice woman. I feel bad saying she’s a big part of why I felt so uncomfortable.

Just a reminder: I am Canadian, but I live in Germany.  I do speak German, however it is not my native language and therefore not my language of comfort. Handling such a sensitive situation would have been difficult already, and I had given myself the added stress of facing it in a foreign language.

Soon after my arrival, one of the nurses came to sit down with me.  She had a stack of papers, a whack of questionnaires to fill out together.  We sat and spoke for about twenty minutes.

Why are you here? – My doctor insisted.
You’re not German, I see.  Where are you from? – All the way from Canada to a German psych ward.
What sort of symptoms have you had?  – What symptoms haven’t I had?
Are you suicidal?  – Isn’t everyone?
(I was very cynical.)

I was told all about the daily routine:  7:00am wake up.  Check the schedule upon waking up – if your name is on the list, go for blood work before breakfast.  8:00am breakfast.  Medication rounds.  Meetings with doctors/therapy sessions.  Lunch at 11:30am.  Medication rounds, where required. Visiting hours.  Dinner at 5:00pm.  Medication rounds, where required. More visiting hours.  Quiet time after 8:00pm.  9:00pm: final medication round.  Lights out at 10:00pm.  Try to sleep through the noise of disturbed people all around you.

The schedule didn’t sound so bad (apart from the 7am wakeup, of course). I was happy to hear that I had lots of time for visits, and even happier to find out that I was allowed to leave the building during those hours.  The nurse was sure to remind me that – at least until they got to know my patterns and behaviours – I would not be permitted to leave without supervision.

After the nurse told me all she set out to tell me, I found myself alone in my room, desperately wanting to go home.  I knew there was a common room where I could entertain myself with board games, cards and fellow crazy people, but I wasn’t particularly interested in any of it. 

As I was lying in my new bed crying, Evie came in and started talking my ear off.  She spoke incredibly fast, and it was sometimes difficult to understand her.  She’d ask me all kinds of questions, but she never gave me enough time to answer before she moved on to the next one.  She was very friendly, and wanted to introduce me to everyone else in the ward.  I didn’t want to make friends.

That hospital had been home to Evie for over six months by the time I met her, and she had no idea when she would be allowed to leave.  Unlike me, Evie wasn’t there voluntarily.  Even more unlike me, she was more than happy to stay.

My first meeting with the doctor was pretty uneventful.  He asked me the same questions the nurse already had, and set up some appointments for the upcoming days – blood work, electrocardiography and an MRI.  He also gave me a few questionnaires to fill out, to help with coming to a diagnosis.

In the afternoons and evenings, I was lucky enough to have friends come and visit me.  I don’t think I spent a single afternoon alone.  That helped keep me sane, but also reminded me of how much I knew I didn’t want to stay there anymore.

At the end of the day, I just felt like the hospital was not the place for me to get better.  Being surrounded by so many people whose mental afflictions were much more severe than mine just reminded me of where I might end up one day.  I didn’t like that constant reminder.  For me, it was easier to imagine myself living a normal, happy life if I was surrounded by normal, happy people.  I felt like the hospital brought me further into my illness instead of bringing me to a point where I believed I could combat it.

This is not the same for everyone, as I learned from Evie.   She improved there.  She actually got the help she needed there, because it was the best, most comfortable option for her, and she wanted it.  She needed the stability.  She needed to be woken up every day.  She needed to meet with doctors.  She needed to have her meals prepared and placed in front of her three times day.  She needed routine created for her, because if left to her own devices, she’d never have it.  I didn’t feel that was true for me.

I decided one week was enough.  I was checking myself out.  The doctors and nurses tried their best to convince me to stay.  They reiterated again and again that constant observation and supervision was the best way to diagnose me.  I agreed.  However, I protested and stood my ground.  I was leaving.  I didn’t want to risk coming to a graver diagnosis, and I felt that was the only possible outcome if I stayed at the hospital.  With reluctance, they wrote a synopsis of my stay and passed all necessary information onto my psychiatrist.

I left with a diagnosis of “suspected bipolar disorder, type 2”. Several months later, I finally made a follow-up appointment with my psychiatrist.  Several months after that, I was diagnosed again.  This time, with schizo-affective disorder.  And thus began my “recovery.”

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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.

Here’s why you should talk about suicide

Suicide is the loss of a life at the hands of the very person living it.  It is raw, and it is scary.

Suicide is a sensitive subject – one that not everyone is comfortable with. People often shy away from talking about suicide because it’s not something they want to accept as relevant – they’d rather ignore it and hope it goes away.

Unfortunately this creates a vicious cycle, as it instills a fear in the suicidal – they are afraid that they will be judged and ridiculed for acknowledging their demons, and so they choose to suffer silently.  If people don’t openly talk about suicide, those suffering from its hold will not feel comfortable in coming forward to ask for help. They will be much more likely to succumb to their dark thoughts if they aren’t confident someone can help in fighting them off.

The depressive suicidal don’t believe in getting better – they don’t believe it’s possible.  They feel like they are stuck.  Hope is a foreign concept.  They don’t know what hope means anymore because they’ve forgotten what they’re being hopeful for.  They’ve forgotten what it feels like to be happy, and so they feel like happiness just doesn’t exist for them.  They aren’t hopeful they’ll get better because they can’t imagine a different life for themselves; they don’t remember life before depression took over.

Although society is headed in the right direction, there is still a strong stigma attached to mental health disorders and suicide.  We can’t fight that stigma with silence, and so we need to get people talking.

We need to open up.  We need to share our stories.  Because by sharing our stories, we can open eyes.

We can save lives.

Many of those we speak to will have never experienced this sort of thing for themselves.  Some might have a friend, a sibling, a parent or a child, who has.  We might be speaking to some people who have never ever knowingly been touched by suicide.

However, I can guarantee that we will also be speaking to people who have.  We might even unknowingly speak to someone who already has a plan.

We can be the reminder to that person that there is another way, even if they can’t see it right now.

We can be the reminder that they’re not alone, even if it feels like they are.

We can be the reminder that it’s okay to talk about it – and that they should talk about it.

We can be the reminder that they can get help; that things can change – that things can get better.

We can be the reminder that suicide doesn’t always win.

Giving up on Depression

When I’m depressed, I can’t remember what it feels like to be happy. I forget that I’ve been happy before. I believe I’ve been like this forever: this is the only state of mind I’ve ever been in, and it’s the only state of mind I will ever be in.

If somebody on the outside is telling me, “it gets better,” or “you’ll be fine.” It just makes me more angry. All I can think in those moments is, “yeah that’s you. You might feel better later. You can remember what it’s like to be happy. Yeah, that’s you – that’s not me.”

I get so delusional when I’m depressed that there is no convincing me – at least not from a third party. When I read my own words, though, there’s just no denying it. So when I’m in a good mood, I try to write about it. And then I read it when I’m depressed.

Sometimes I think, “yeah well, I felt like that before, but I’m never gonna feel that way again.”  But in the back of my mind, there’s always that thought that, no- you know what- that was me. Those were my thoughts. And if I’ve been there before, after I’ve been in a state like this, then it’ll happen again; I will climb out of this.

When I’m depressed, I think that everyone is against me. I think that I’m useless and I think that nobody wants to be around me, and the only reason people are – if they are – is because they feel bad for me, or they feel guilty, or they feel responsible. I hate myself and I can’t even imagine how anyone could feel any differently.

I forget that people are there with me because they want to be. They’re there for me because of the non-depressed me. They remember the real me, who’s hiding somewhere underneath this blanket of depression that is sometimes all too consuming. They remember that person and they want to help fight to get her back. That’s why they’re there.

On one hand, I want someone there with me. I want to know I’m not alone.

But on the other hand, I don’t want anyone around because I don’t want anyone subjected to my negativity and I don’t want to have to explain myself to anyone.

I want to just cry, and feel bad for myself, and ignore everything else in the world and just live in my fucking miserable bubble. Because it’s really all I feel like I can do.

These are the thoughts that are going through my mind:
“I’m a piece of shit.”
“Everyone hates me.”
“They want to have their own life without me in it.”

When I’m in a better state of mind, I feel bad for myself and for the fact that I cant realise how much people actually love me. 

I don’t think anyone really resents the person that’s projecting these feelings. They resent the depression – the thing that’s making the person be that person, because they’re not that person.

So this is what I want to say, to anyone who recognizes the feelings I described above:

This isn’t who you are. This is a state that you’re in. This is something that can be dealt with.

You feel like there is no light at the end of the tunnel. You feel totally useless and helpless, and hopeless, and worthless. You feel like you’re not even here anymore – you feel like you’ve already died. And on top of that, you genuinely believe that nobody actually wants you around.

You think that you’re taking away their fun. You think that you’re taking away all of the happy feelings that they could be feeling, that they cant be feeling because they’re busy feeling your sadness with you. But they can always leave – they can walk away. If they don’t want to be there for you then they don’t have to be there for you.

There’s always gonna be people who just don’t get it. People who just brush you off – the worst is when people accuse you of making shit up. They just don’t understand. They never will. And that’s okay.

Nobody wants to see you sad. But it’s okay that you are. People can help you get out of that sadness. Whether it’s therapy, binge watching a tv show and pigging out on ben and jerry’s with a friend – you don’t have to say a word. Whether it’s medication, or going for a run, or reading a book and forgetting about yourself for an hour or two.

Or whether it’s feeling everything that you’re feeling – all of those terrible emotions. Let them consume you for a bit. Feel shitty. Feel terrible. Feel awful. Feel everything and then let yourself become numb to it. And then, take a deep breath. Cry yourself to sleep. And then get up in the morning and read your happy thoughts. Try to picture yourself at the moment you wrote it – try to remember how great you felt. The same person who wrote those happy things is the same person who’s feeling shitty right now.

You were happy. You can be happy again.

Don’t give up. Even if it’s all you wanna do. Because even if you can’t see a future for yourself right now… you still have one. And you can figure out what it is.

Just don’t give up.

The beginning of schizo-affective disorder

Looking back, I realise I was 21 when schizo-affective disorder decided to make itself known. This is around the time it strikes most of its victims – I was no different. I wasn’t familiar with the disorder back then, but we’ve become pretty well-acquainted over the last couple of years.

I didn’t just wake up one day and recognize it – I think I always knew I was a little off. But, I guess things just gradually got more and more ‘off’. Eventually there was no denying that my mind was no longer stable.

I’d been on anti-depressants regularly since I was 19. I had never seen a psychiatrist; I never felt like I needed one. My GP and I decided together that my condition wasn’t severe enough to warrant the long wait it would take to get me into a specialist. He prescribed me some Sertraline and sent me on my way.

It helped. Until it didn’t.

After being on varying doses of Sertraline for over a year, my symptoms started to worsen. It went from bad to ugly. Quick. I later found out that while Sertraline can help depression, it can actually have negative effects on those with schizo-affective disorder.

First, it started with the sadness. That overwhelming feeling of worthlessness. That stereotypical depression everyone talks about. I felt useless. I felt alone. I felt tired. I cried. All. The. Time.
It didn’t matter where I was, or who I was with. Those feelings were constantly nagging at me, and I couldn’t silence them no matter how hard I tried.

Then came the madness. I went berserk. I would flip out over nothing. I was incredibly jealous. I was constantly angry – irrationally angry. I created these ideas in my mind – these scenarios where people were secretly plotting against me. Everyone was an enemy. Everyone hated me – I knew it. No one actually cared about me. They didn’t want me around.

That would loop around again, and after a few weeks of being angry all the time, I’d snap back to reality. For a minute. I’d realise how insane I had been – I’d look back at all the things I had said to people, the thoughts I had had about people, and I’d hate myself for it. I’d be embarrassed by it. And then, I’d get depressed again. I’d tumble back down the sadness tunnel and I wouldn’t have the energy – or the desire – to climb back out.

One day in particular stands out to me.

I finished my day at work, and walked outside. It was always like this: an almost immediate change in my state of mind. At work, I could pretend. Because I had to. Outside of work, the break was over.

I knew I didn’t trust myself that day. I knew that if I was left alone, I was going to do something. So I called Nick. I asked him if he would hang out with me when he got home from work. It was a Friday night, and he had plans. Obviously. Expected. It’s Friday. People go out on Friday. It’s the end of the work week. We live in the beer capital of the world: Friday is beer day!

But it wasn’t okay for me, and I knew it. But, I cared more about what people thought of me than I cared about my actual self. I didn’t want to be the ‘nagging girlfriend’ I already feared his friends thought me to be. So I pretended it was fine.

“Okay, so I’ll be alone tonight.” I thought about it, and all I could do was cry. It was one night. One night I was going to be alone. Just one night, and I couldn’t handle it. I can’t begin to explain what was happening in my mind, because I’ll never understand it. It isn’t me. I just knew I couldn’t be left alone.

So I sent him a picture of the train tracks, and then I turned off my phone.

Why did I send him a picture of the train tracks? A number of reasons, I’m sure.

I think the number one reason though, is because at this time, I still struggled with actually asking for help. I hadn’t admitted to myself out loud yet that I needed it.

I took the first step by calling him and asking him to stay with me. He said no, but only because he had other plans. And because I never told him I needed help. I was really struggling. But how was he supposed to know that? Having him reject my well-disguised offer to save my life left me feeling even more hopeless.

But I still didn’t want to give up just yet. So I sent him those train tracks. Then, I turned off my phone, and I went home. I ran a bath. I had a few drinks. I got in the tub.

Unbeknownst to me, Nick is in a panic. He probably realized, thanks to those train tracks, what that phone call really meant. He probably remembered my unsteady voice on the phone, and pieced it together. After trying and failing to phone me, he left work early and rushed home. He got there just as I was falling asleep in the bathtub.

This was only the first of several near-suicide attempts. Thankfully, I never even came close to accomplishing what my confused mind was telling me to do.

After that day, Nick never even hesitated about staying home. I’d get angry at him for it. I’d blame him for his friends hating me. After all, they ‘hated me’ because I was the ‘nagging girlfriend’, right? What do nagging girlfriends do? They prevent their boyfriends from going out and having fun. Ultimately, yes, I was preventing him from going out and having fun. But I wasn’t doing it on purpose, and he was never resentful to me. It was always his decision to stay home. That’s all that should have mattered to me (but of course I didn’t see it that way then).

This was only the beginning of what turned into over a year of serious struggle. Not only for me, but for everyone around me.

My doctor decided it would be best to get me into a clinic to diagnose me properly. I agreed to go for two weeks.

While I was in the psychiatric hospital, I had to fill out a number of surveys. I had regular meetings with psychiatrists. I had brain scans. I went in for electrocardiography. I had to have blood and urine tests done. They encouraged me to attend group therapy sessions, but I never went. I left the hospital after one week, with a diagnosis of bi-polar disorder type 2.

After my experience in the hospital, I didn’t want to see any doctors for a long time. I avoided my psychiatrist like the plague. I didn’t go to my appointments, and I never called to reschedule them. I took the medicine they gave me at the hospital until it ran out. Then I didn’t take anything at all. I’m sure I don’t need to tell you that I started to fall back down the tunnel within a few days.

Even then I was still stubborn. It had been so long by this point that I was embarrassed to go back. I thought about getting a new doctor altogether, just to avoid telling mine why I disappeared. Then one day, something took over me. I was in town, and almost on auto-pilot, I walked to my psychiatrist’s building, went up the four flights of stairs to his office, went straight in, and asked for an appointment ASAP.

They hadn’t seen me in months. I never checked in after leaving the hospital – somewhere my psychiatrist had actually sent me himself. They weren’t bothered at all. They were just glad to see me again, and booked me in for the following week. Breathe. Relax. Relief.

When I finally went in for my long-awaited appointment, my doctor wasn’t happy with the diagnosis I had been given at the hospital. He wasn’t happy with the medication I had been on, and he wasn’t happy with the fact that I only stayed for one week.

He wanted me to go back. I refused. He said it was for the best – that way I could be constantly observed during all courses of whatever illness I was suffering. I could get a proper diagnosis and treatment could start right away. I still refused. He couldn’t admit me against my will, so he had to accept my choice and treat me outside of the hospital.

He gave me more surveys to fill out, and started me out slowly on some new medication. The first problem he wanted to tackle was my sleeping patterns. Or, lack thereof. He figured if I could get some well-needed sleep, my head would be more stable overall, and it would be easier to diagnose me. He was right. He prescribed Quetiapine, a god-sent. It’s an anti-psychotic which can be used to treat insomnia in low doses. Perfect for me. It worked, and it still works to this day. But it only fixes half the problem.

We still didn’t know what the other half of the problem was at this point.