Transcript
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This is Polarized Lens with Jennifer Merchan.
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Polarized Lens is a podcast that examines life through the filter of bipolar disorder.
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Created and hosted by a person living with bipolar disorder, Polarized Lens aims to explore the challenges of that mode of life in this neurotypical world,
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raise awareness, and help those who want to understand more about bipolar disorder.
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Content Note What follows is a subjective description of an inpatient stay in a mental hospital.
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Suicide, miscarriage, and other upsetting subjects are mentioned.
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Fellow patient Anne's name and her personal details are fictional, though her story is not.
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And my opinions, especially about therapy, are just my opinions.
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Episode 5 No Exit. Hospitalization was one of those defining moments.
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There was a before and there was an after.
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Before I was diagnosed with bipolar disorder and after I was diagnosed with bipolar disorder.
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The hospitalization itself was a liminal time, barely remembered, and then only with some effort and the help of a journal I kept while there.
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The night I was admitted, I was assigned a room, which came with a roommate.
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All I remember from that night is stashing my plastic bag of clothes in the wardrobe, while my new roommate talked at me almost incessantly about all manner of things, including her urinary retention issues.
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But on that first night, I asked for and was given a notepad and a ballpoint pen.
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I still have the sheets from that notepad that became my journal.
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All I recorded that night was how Paxil makes me feel.
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Agitated and like a coiled spring, irritable to irate and intolerant of others.
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This came up because I had stopped taking it and was feeling better without it, but the hospital was going to have me resume it.
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I also scribbled something about how I had no real local support structure.
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The first full day, Day 2, starts with quote, expressive art is a coping skill, end quote, and covers seven pages in my barely legible handwriting.
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I was wakened at six in the morning to talk in the common room to the psychiatrist who told me I had been diagnosed with bipolar two disorder and needed lithium.
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I am 100% certain the doctor actually explained both the diagnosis and the need for medication, but I 100% did not find that explanation worthy of the effort of recording the details.
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Then I was left with enough free time before recreation therapy that I began to feel trapped, probably because I was.
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There is nothing that describes recreation therapy in my journal, but from what I can remember, it was just art therapy with paper and crayons.
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Later that morning, I was introduced to some of my fellow patients in a group session.
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An HIV positive minister who had just been diagnosed with bipolar disorder.
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A visibly distraught woman who was recovering from a miscarriage.
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Someone who perceived her hands as unconnected to her body and acting on their own.
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Two people who expressed a need to learn coping skills.
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An older woman with dementia, whom everyone called Granny.
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And two other women who seemed to have dementia, but as I later learned, were getting electroconvulsive therapy, also known as ECT, treatments that wiped their memories.
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I missed the remaining patients' intros because I was told to stand in line for my morning medications, which included my first 300mg of lithium, to which 600mg would be added that night.
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The group session helped me to feel better about my own situation.
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I was no longer the lone freak who couldn't deal with anything.
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And the pressure to act normal, which I had felt even with my parents, was gone.
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So were the pressures of daily life, the constant backlog of all the things that need to be done that lives in the back of your mind.
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These are some of the reasons they lock you away and limit your contact with the outside world.
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Because it imparts a certain amount of mental freedom, freedom to stop worrying and start healing.
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We had all also been relieved of our shoelaces, belts, hood strings, and razor blades, if we had them.
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But that was for a different reason.
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At 10.55 that morning, I met with a social worker who estimated a 4-5 day stay and told me that I had to settle the issue of where I would live before they would release me to outpatient treatment.
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And that I had to call my then husband Bob to settle this issue and let him know that I was in the hospital.
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You might recall that he had not so much left me as removed me from our home.
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Around 11.30, during skills group, I noted in my journal that I had started to feel dizzy, to have trouble concentrating, and to feel a heaviness in my head.
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In other words, although I didn't know it at the time, I started to feel the side effects of lithium.
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After lunch, my mother called and promised to bring me a book so I could fill all the free time that wasn't on the schedule.
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I called Bob's phone and left a message with my contact information and explaining where I was and that I needed to talk to him.
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By three that afternoon, I had figured out that all the personal time was actually so that we could recover from the people talking at us and yelling.
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There was so much yelling. And my roommate finally succeeded in urinating on her own, on herself.
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Evidently urinary retention is a side effect of some of the older psychiatric medications.
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She struggled with this the entire time she was there.
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I spent 4.30 to 5.30 writing about how bored I was and complaining in general.
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I also note, quote, journaling is apparently an encouraged coping skill, end quote.
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By 5.30, I was reporting that Bob had called me back, saying that he wanted to visit.
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I expressed some opinions about that, and then I complained some more.
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Some of my observations unrelated to Bob are that everyone on the ward notices and then loudly announces when something is not straight, as if everyone has OCD,
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and that the heavier your psychiatric burden is, the quieter you are, with the exception of the yellers, who tend to be very troubled.
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My roommate was a yeller and also talked to herself constantly.
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Between the loud TV and the yellers, the ward was pretty noisy.
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By 8 that evening, visiting time was over. I hadn't noted when it started, but I think it started at 7.
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My mother had brought a book for me and Bob had not shown.
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My journal later records my inability to read and these thoughts, quote,
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I hope I get better, but right now, surrounded by people who are so miserable, even though they're on meds, it seems hopeless.
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The worst thing is that we all feel comfortable here together, but we're freaks outside of these walls, end quote.
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At 10.25 that night, I stepped outside my room to allow my roommate some privacy while getting catheterized.
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I called Bob, who explained that he had gotten physically ill on his attempted drive to the hospital
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and said that he'd try again tomorrow after his appointment with our shared therapist.
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Then I wrote, quote, Granny's talking to me, but she forgot what she was saying.
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She has an ankle tracker bracelet. She's obsessed with locking things, end quote.
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And that's how I closed out day two, which was the first full day of my stay.
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On day three, after a night of troubled sleep, my psychiatrist traded the Ambien I was taking for trazodone,
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which I did not remember at the time makes me stupid and sleepy all day.
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I had also begun to feel the benefits of lithium, not just the side effects.
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I felt calmer and less irritable, which was good because the weirdness surrounding my roommate's bathroom issues escalated.
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The staff had started locking the bathroom my roommate and I shared.
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In my journal, I mused about how the staff doesn't really know what to do with the veterans of psych problems
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and how disappointed and how hopeless I felt.
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The therapy that they preached inside the hospital was no different from the therapy found elsewhere.
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But what did help was the medication and the opportunity for close observation that being there afforded the doctors that doing the prescribing.
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They could fine tune the medications while I drew pictures and learned coping skills.
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The rage monster inside of me didn't disappear when I accepted reality and dealt with emotions.
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It went away when the staff fed me 900 milligrams of lithium every day.
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Therapy helps, but it is secondary to medication for serious mental illness at the height of a bipolar episode.
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You start to feel better and the therapy helps reorient you to the real world and all its expectations.
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But I wasn't there yet.
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In group therapy that day, I heard some of my roommate's story.
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Her father had pulled a gun on her.
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I don't think I was ever clear on the reason why.
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She was bipolar and suicidal and her boyfriend wanted her to leave the hospital.
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And so it seemed did she.
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At group lunch, one of my greatest fears came true.
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In the cafeteria, I saw one of my students across the room.
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He waved at me standing with my group in line and I waved back at him standing with his group in a different line.
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I should have been mortified, but I had too much lithium in my system for a strong emotion to manifest itself.
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I slept during various schedule activities that day, probably because I was adjusting to the lithium.
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My roommate had to wake me to go to dinner.
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Much of my journaling that evening was embarrassingly, musing about Bob.
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He had told me he would visit that night, but never showed.
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When I spoke to him about it, he reaffirmed that he wanted to split.
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And I think it was at this point that I said, fine, but you're moving out of the apartment.
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And he agreed to this arrangement as long as I kept the cats.
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I noticed that night that my verbal abilities were slipping.
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I was having trouble both spelling words and choosing the appropriate words for what I was trying to say.
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As I know now, this was yet another side effect of lithium.
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That night, the staff withheld my lithium dose because the doctor had seen a small abnormality on my EKG and had sent it to the cardiologist for analysis.
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This would also be my first night on trazodone.
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I woke up on day four miserable because I had not been able to sleep much, and the sleep that I got was filled with nightmares.
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My roommate had verbally fought with one of the staff in our room in the middle of the night as well.
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I had finally begun to accept that I was on my own and was depressed about it.
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I had no job, no car, and apartment full of cats to take care of.
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I had no more friends left in that city.
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I needed a new therapist upon leaving the hospital.
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I felt like my head was wrapped in cotton or filled with lead.
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I couldn't read or even think.
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I wondered how I would be able to go to graduate school like this.
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I was hopeless and unmotivated.
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I had felt I had nothing to look forward to but pain and struggle.
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I was so bad off that I actually shared in one of the group sessions.
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For my trouble, I had the affirming experience of everyone being horrified at Bob's actions and reactions over the course of this bipolar episode.
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Someone in the group phrased it in a way that truly opened my eyes.
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He had used my illness as a tool against me, and it had been a huge betrayal of trust.
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I cried in the shower that night.
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Therapy had finally done something for me.
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Day five was a Saturday.
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That morning was spent in our room because one of the patients was walking around the ward yelling about killing her family,
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which apparently made most of the other patients really nervous.
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I had resumed taking lithium, so I was not nervous about it, just annoyed.
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I felt better that day but was bored.
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It was also Valentine's Day, but that's a story for another day, maybe.
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Sunday was quiet and boring after a night full of weird dreams, but there's something else I want to talk about.
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There's something about my time in the hospital that's not in my journal but affected me so much that I still actually remember it.
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This happened during unstructured time in the common room.
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One of the ECT patients, let's call her Anne, had returned from her treatment in a wheelchair,
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and a small group of the other patients had gathered around her.
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The more experienced patients, that is, the ones for whom this hospital stay was not their first inpatient experience,
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led what amounted to an impromptu session, the goal of which was to reorient Anne back to the present.
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The treatment had unmoored her from time and space.
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She had no idea who she was or where she was.
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These veteran psych patients had memorized her personal details and were repeating them back to her.
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Your name is Anne. You are 53 years old. Your husband's name is George. You are in a hospital.
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I don't remember when during the week this happened, but it has stayed with me for 20 years.
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This is how I learned about the devastating short-term effects of ECT.
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Before that experience, I had not known personally how ECT affected a patient immediately after treatment,
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and to see it firsthand was dumbfounding.
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Monday was my last day in the inpatient program.
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I was woken at 5.45 that morning to see the psychiatrist.
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My journal tells me that I was supposed to see Bob that night to hash things out,
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that I was happy I would see my cats again, and that day hospital would begin on Wednesday.
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That's the end of the inpatient part of the journal.
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I don't remember what happened that last day,
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but I'm going to assume that my mother took us back to my apartment, where we both stayed until some time later.
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Unsurprisingly, Bob never showed to hash things out. Also a story for another day.
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This week of inpatient hospitalization was a traumatic experience,
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but it sorted me out and set me straight in a period of dire need.
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It also gave me the time and space needed to begin to recover from several simultaneous devastating life changes,
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one of which was obvious in retrospect, but completely unexpected when it happened.
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And while therapy continued to fall short of my expectation,
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my fellow patients helped me come to terms with my diagnosis and provided comfort and shared experiences.
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I'll tell you about day hospital next time in Episode 6, Day Hospital. See you then.
