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macgyvermedical · 1 hour

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My Experience in Inpatient Psych

So I know a lot of people on here have talked about their experience in inpatient psych facilities, but I'd like to add mine just to give all you writers out there a writer-focused one. It's below the cut just in case you have to sit this one out for your own reasons.

To give you some background, I am 30 years old and have had hallucinations since about 16 and bizarre intrusive thoughts (someone living in my house that wasn't supposed to be there, somebody poisoned my walls, etc...) for about a decade, as well as very severe anxiety since I was about 3 years old. This is something not a lot of people know about me, even people I am friends with IRL.

The only thing I am actually diagnosed with is anxiety, which I'm starting to think is a failing of the psych systems I have been a part of. I have had counseling off and on and prior to this hospitalization I took escitalopram, aripiprazole, and gabapentin prescribed by my primary care doctor- all for the severe anxiety.

Quite frankly, I should have been in inpatient psych at least a few times before this, and it's by sheer dumb luck that I've survived to continue this blog.

On Friday, I was at home alone and made a few pretty bad decisions. I wont say what they were because frankly they're embarrassing, but they have to do with self-harm. I was scheduled to work Saturday and at about 9pm I realized that if I drove myself to work I would crash my car. Since my wife drives me sometimes, I figured I would just ask her to.

I told my wife and she asked- even if she drove me to work, since I was a nurse, would I be able to keep myself safe around insulin or other potentially dangerous drugs? I couldn't answer that question. We talked for a couple hours and came to the conclusion that I probably needed to go to the emergency department.

At this point I figured they would evaluate me and release me because I couldn't possibly meet the criteria for inpatient. I was wrong in this assumption. After telling them the decisions I had made that day, the feelings of wanting to die in a car crash, plus about a previous attempt, they recommended inpatient. Turns out, when you're a nurse, you can make some really bad life choices with the knowledge you have, and they didn't want to take any chances.

I was given paper scrubs to wear (so I couldn't hurt myself with my clothing or a hospital gown). I was also given a patient companion (someone who sits in the room and makes sure you don't hurt yourself).

They gave me the option of signing myself in voluntarily, or putting me on a writ of detention. A writ of detention is a piece of paperwork that allows a medical professional or law enforcement officer to hold someone for 3 days in a psychiatric facility against the person's will for the purposes of psychiatric treatment. Whether you sign the voluntary or get placed on a writ, you cannot sign yourself out. You need to wait until the psychiatrist taking care of you thinks you're ready to go.

I didn't believe at this point I needed to go inpatient, but I took the voluntary option because there are some perks, like being able to leave within 3 days if appropriate. At this point I was convinced I was probably going to have to call off work Saturday and Sunday, probably be out of the hospital Monday, have a few days to rest and be back at work on my next scheduled shift after that, which was Thursday.

Well, that's not what happened.

Because of some of the decisions I had made, along with bed availability, they wanted to keep me in the observation unit overnight before they sent me to psych. I stayed overnight in a unit that shares staff with the unit I work on, so I was taken care of by my coworkers. This was surprisingly not that bad. I like my coworkers and they were really professional about it.

Saturday I felt like I was in a fog all day. I couldn't watch TV. I couldn't color or write. I worked out some in my hospital room and paced the halls once or twice. Mostly I hung out with my wife and occasionally talked with my companion, but even talking was difficult. I had refused ativan because I felt like I had no hope of finding a medication that made me feel better, and I figured I didn't want to take the one medication that might actually work and then not be able to get it ever again.

Around 7PM I took a 45 minute ambulance ride to the facility. Getting my blood pressure taken is a big anxiety trigger for me, but my brain felt so scrambled that I couldn't express this well. They took it every 10 minutes on the ride there and by the time I got there it was in the 170s/100s (BP goes up when you're having severe anxiety). This was not their fault of course, but no matter how much I thought about telling them or refusing the BPs, I just couldn't do it.

When I got to the facility I was greeted by a tech who took my BP again (150s/90s this time), showed me around and looked through my personal belongings (basically just the clothing I came in with since my wife took my phone and wallet knowing I wouldn't be able to have them on the unit) to make sure I didn't have anything I wasn't allowed to on the unit. She showed me around my room and was really thorough with telling me how things worked, what the rules were, etc..

The rules included:

No patients allowed in other patients rooms

No personal belongings that had strings, belts, or laces, or that could be used as a weapon

No caffeine after lunch and no free access to caffeine

No personal electronics (including eReaders and watches). There was a TV in the day room and 2 phones mounted to the wall for patient use

A little later my nurse came into my room and asked me a ton of questions. Here's the thing about any hospital- you get asked the same questions over and over. By the time I'd gotten there I could give my story in under a minute. Or at least, that's what it felt like. There were only 2 clocks on the unit, at the nurses stations.

The unit itself was laid out in a "T" shape. There was a main nurse's station at the place where the two hallways intersected. At the end of the long hallway there was another smaller nurses station, a cafeteria/day room, and a "comfort room" which was a small room off the day room that had a collection of the oldest and worst donated books that have every come together on a bookshelf.

I did some pacing that night and then went to bed, but didn't sleep particularly well.

On Sunday morning the tech woke me up to take my blood pressure, which was, not unsurprisingly, still high. It was about 5 AM so I got up and paced the longer of the corridors for about an hour. Breakfast was served at 8 and the food wasn't that bad. The coffee was about the worst I'd ever drank, which I suppose helped with the no caffeine goals.

Just after breakfast I met with a psychiatrist on an iPad for about half a minute, and I'm not exaggerating there. The only questions he asked were whether I was suicidal and whether I would be fine with tripling my dose of aripiprazole in light of the hallucinations. I had had a 50-lb weight gain in the last year so I asked to switch my med. He switched the med to cariprazine. That was all.

I had a much longer meeting with my nurse later. All the nurses did an excellent job of assessing me, asked tons of questions, and it seemed like they really tried to figure out what was going on. That day I also met with a social worker, and a therapist, and a nurse practitioner. Each of them did an assessment to see what my needs were while I was there.

There was also a music therapy session where I cried my eyes out to Because of You by Kelly Clarkson.

I was really tired by the end of the day but I also didn't think I could sleep so I asked for trazodone. I should clarify that when I say "I" in this piece I really mean my wife convinced me to ask because I legitimately didn't believe I needed or deserved any of the things I asked for at this point. To my utter shock and surprise, they gave me the trazodone.

My first night on trazodone was amazing and I realized I hadn't slept well in a long time. With trazodone I fell asleep and stayed asleep until the blood pressure cart came rolling down the hallway at 5am. The second I got up on Monday morning I was wide awake.

I paced a lot Monday. I went to a goals session in the morning where I gave a goal to write 3/4 of a page. I didn't know if I could do it or what I was even going to write about, but I know I like to write and it might be a reasonable introduction to getting back to life.

I also was having kind of a rough day brain-wise. My brain was coming up with all the ways I could hurt myself in my room. There weren't a lot of them, but it was trying. I told the nurse during her assessment and she asked if I felt I could keep myself safe. I asked her what she would do if I said no. She said they could move me to a more secure part of the unit and give me more supervision. I knew what part of the unit she was talking about, and I didn't want to go there (no space to pace, and pacing was keeping me alive right then). So I told her I could keep myself safe (if anything, the idea of moving was good motivation to do stay safe in itself). I hallucinated some black and white blood cells falling from the ceiling and music coming out of my vents.

I also had another meeting with the social worker to figure out discharge plans. I voiced in the meeting that I wasn't sure that I could trust my wife, since it felt like at the time she was the one who exaggerated my symptoms to get me in here. The social worker said we had really good communication skills, since this was something I felt needed to be said in front of both of them and we both stayed really calm through the whole thing.

I finished the day with an art therapy session that really helped me turn a corner. The prompt was to draw the emotion(s) you felt right now on one side of the paper, and to draw the emotions you wished you could feel on the other side. For the first time I realized that my emotional state was actually really bad and that the suicidality hadn't come out of nowhere, and that I needed help.

When my wife came to visit later that night I was able to tell her about my breakthrough, even though I still felt a little bit like she had done something to get me in here and I still wasn't sure I needed to be inpatient.

Tuesday was a lot better. I felt like I had woken up out of some kind of fog and I had no idea how long I'd been in it. I went to goals group, a spiritual group, and group occupational therapy. My goal was to be more social and I made a friend and we paced together and worked out. I read a quarter of The Martian by Andy Weir (my wife brought it for me because the best thing on the bookshelf was Louis L'Amour). I wrote about how good I suddenly felt. Turns out, I thought, a few days of good sleep, lots of therapy, and a new medication or two will really change things.

A quick side note about The Martian. I highly recommend it to anyone who is chilling in a psych hospital but has the ability to read while they're there (I sure didn't the first few days). I don't really know why, but the first few times I read it, I felt like they had created this superhuman character in Mark Watney just so they could throw a ton of wild things at him for the story. This time reading it, as a suddenly not suicidal person, I realized anyone with Mark's skill would have done the same thing and not just died on Sol 7 to get it over with.

Wednesday I woke up not feeling nearly as good as Tuesday, but still like the fog had lifted. I was a little disappointed (I hallucinated my cat (thanks for coming to visit me, Corina), some spiders, and just felt kinda meh. But I remembered how good I felt the day before, and that really kept me hopeful about going home.

I saw the psychiatrist again and asked to go home. He joked a little about me staying till Christmas, but ultimately he said as soon as his note was in I could go. I ended up leaving at about 12:30 with my wife.

In the time since leaving I have required a lot of support from my wife. The medications are all locked up, so are the blades and anything I could use to hurt myself. My wife has me in eyeshot at all times. I can't drive due to intrusive thoughts, so she does all the driving now. I quit my job because I feel like it was a big part of why I ended up as bad as I was. As someone who has been a pretty independent person this is a big change of pace, but something that is really necessary to my healing.

Ultimately at the end of my hospital stay, I was prescribed escitalopram, gabapentin, trazodone, cariprazine, and then a few days later propranolol. I'm currently on a total of 5 psych meds and honestly I don't care one bit because its so much better than being not on them at this point in my life.

#mental health #personal #writing reference #inpatient psych #suicide mention #hallucination mention

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