Monday, October 26, 2009

I'm Listening

This post is for any of our blog readers who have ever been involuntarily admitted to a hospital or treated with medication against their will. I'm trying to put together some ideas for things my patients can do to help live with their symptoms (and help them avoid imposing their symptoms on others) without the use of medication.

So my questions are:
1. Which symptoms bothered you the most and what did you do to deal with them?
2. How could you tell when your symptoms were causing problems with others?
3. If someone told you that you were doing something unusual or bothersome, would you have listened when you were sick?
4. What was the most helpful thing someone said or did to help you get by when you were ill?
5. When you were on the inpatient unit, did you notice other people's symptoms? How did you deal with them?

The things you tell me may help my patients, so please speak up.

12 comments:

The Silent Voices in my Mind said...

Is there an email address I could send this reply to? I'm not comfortable putting it out there for everyone to read, even anonymously.

ClinkShrink said...

Silent: Sure! Send email to ShrinkRapBlog at gmail.com.

Anonymous said...

Hello

I can reply more specifically later, I was just wondering if you are already aware of the pioneering work that has already been done in this field, by those such as Jung & John Weir Perry among many others.

http://spiritualrecoveries.blogspot.com/2006/05/dr-john-weir-perry-diabasis.html

http://www.dantescure.com/

http://www.moshersoteria.com/

Here is a very useful recovery Blog -

http://bipolarblast.wordpress.com/

& a very good series of Blogs on alternative perspectives to altered states -

http://spiritualemergency.blogspot.com/

& there is of course the spiritual emergency network ~

There is a lot of resource material already on-line.

Jessa said...

1. The most bothersome symptoms for me were the straight up depression and anxiety. That constant feeling of utter misery, the constant fear. Yeah, there were other symptoms, but the namesake ones were the worst (which makes sense). Also, the ruminations were pretty bad. My depression and my fears were all I thought about all day long, but it was incredibly unproductive thought that just went around in circles (and that is a large part of why I went on to stop eating and self-injure, to add some variety to my ruminations).

2. My symptoms were usually pretty unobtrusive. Yes, people noticed that I was batshit crazy, and maybe they felt bad for me, but my flavor of crazy didn't really impinge on most other people. The only people who ever really complained were my mom and professionals, as described below. I knew that they were bothered by my symptoms when they said they were.

3. My mom complained about me sleeping all the time, but since sleep was my only respite from my misery for so long, and because my medication made me incredibly sleepy, I didn't change anything about that; I didn't want to and I couldn't have changed it much even if I did want to. And she later told me that my sleeping was upsetting to her because it made her sleep more and get nothing done, so I don't really think it was a complaint that I should have had to heed anyway. If I knew that at the time and was healthy, I would have called bullshit.

I was told by professionals on several occasions that I was being manipulative. In some situations, I was told that I was looking for help in the wrong places rather than going through the proper avenues to ask for help. Now, as a healthy person, I still stand by what I did in going outside the proper avenues because those proper avenues were not helping me and I was still going out of my mind with desperation. The proper avenues very well may not be at fault, but I would rather see someone go outside the proper avenues looking for help than suffering alone.

I was told that I was being manipulative when I did things that the professionals did not understand. When I had a panic attack in a hallway and said that I curled up there in a little ball because I did not want to be seen, they called me manipulative. They believed that I knew full well that curling up in a ball in a hallway made me more conspicuous and that I did it so that people would see me and pity me. I curled up because that was all I felt physically capable of at the time and because I wanted to be invisible. Thinking about things from other people's perspectives (i.e. that I would be extra visible to them) simply wasn't something I was capable of mid panic attack.

In situations in which I was called manipulative, I did heed what I was told. I tried very hard to be aware of when I was being manipulative, but it was impossible for me to stop (because I really wasn't being manipulative at all, in the manner they meant, because I was being entirely sincere throughout all of this, no matter how misguided I may have been). Largely because I was sick, I did listen to and heed being told that I was manipulative and tried to change. If I was well, I would have been able to identify those accusations as the bullshit that they were, and would have named them as such.

Jessa said...

(my comment was too long)

4. The truest thing I was ever told was that nothing was certain and that recovery (from anorexia and self-injury) was different for everyone. That never made me feel better at the time, but at least it was not actively harmful to me at the time or at any point later on.

I was often told that suicide was not an option, which was meant to be helpful, to redirect my thoughts, I'm sure, but had a devastating effect instead (read about it here: http://madewithawesome.blogspot.com/2009/02/suicide-is-not-option.html).

I was told that various treatments would help if I worked at them and gave them a fair shot, and then when so many of these hopes I was given turned out to be false, I learned to fear hope (which I still do, even now that I am healthy). I imagine people say those things because they are confronted with a miserable person and they want to make that person feel better immediately. But this is dangerous; I don't think the risk is worth it. It wasn't long before I learned not to trust those hopeful things I was told and every time one turned out not to be true it caused me to despair that anything at all would help, putting me in a much worse position if no one told me hopeful things they couldn't guarantee in the first place.

A lot of people tried to identify with me and say that they had experienced what I was going though. In the short term, this was slightly comforting, but that comfort was overshadowed by the terrifying implications that so much of the world's population spends so much of their lives so miserable. When I figured out that most of these people were lying to me, this annoyed me.

The single best thing that helped me in the moment and that I can still look back on not traumatized by or mad about, is the rare occasion when someone would just sit with me, knowing that I desperately wanted to cut myself or off myself. Just sit with me and let me curl up against them. Not judging me, not trying to convince me of anything (i.e. that suicide is a bad idea, that cutting will only make things worse), not trying to make small talk with me, just being with me. (This chokes me up.)

5. On inpatient units I noticed people's psychotic symptoms, when they told me hallucinatory stories or whatever, I mostly just humored them. Usually, though, I stayed away from the other patients. I had intense social anxiety and I was terrified of them, not because of any symptoms of theirs, but just because I feared all people.

Anonymous said...

Hi There

Would you mind requesting permission on a mental health forum based in the UK?

These type of requests are usually vetted.

http://mentalhealthforum.net/

Anonymous said...

1. The inability to sleep bothered me the most. I complained to anyone in authority who would listen that I simply could not sleep. I didn't know what else to do, since I was now on the asylum's schedule and it was difficult to even know what time of day it was. I feel I should've been allowed to adjust to my body's own schedule until I stabilized. Eventually, nurses started handing out Benadryl to me.

2. I could tell I was causing problems from the eyerolls I got from fellow patients. Also, I was slightly delusional and believed I could win my freedom by "following the rules" and behaving nicely. During the morning group therapy, every day for a week, when asked about a goal, I said that my goal for the day was to "follow the rules." Other patients flipped out and were ready to attack me, or they gave me the "oh, brother" look. I didn't realize it was because I was being repetitive--I just thought they were against me.

3. I would not have listened to others about bothersome behavior until I heard it from at least 6 separate people.

4. The most helpful thing came from a psychiatrist who decided to level with me and told me how sick I was in blunt, simple, curt language. It was done without this look of concern and compassion and worry about my level of functioning--just speaking to me directly. I was glad to hear what he had to say because it gave me a starting point to want to get better.

5. I noticed anger, paranoia, suicidality, self-injury and lethargy. I reassured the paranoid patient, tried to talk down the self-injurious one, and gave most people their own space to work out their illnesses. Everyone is equal in inpatient care. I never judged, though the staff judged me.

DrivingMissMolly said...

* psychotic patients scared me. I didn't feel safe from them and no one seemed to be around. The nurses where behind an invisible wall when a woman lifted a chair and came toward me. Luckily, her invisible enemy was off to my right so I didn't get brained.

*Reader's Digest Condensed Books helped me. Someone donated many of them to the psych ward and even donated bibles. Having something to read helped pass the time.

*I liked talking to other patients. Some scared me. I remember one beautiful woman who told me whe ran into traffic with her child and that is why she was there. SHE HAD DEAD EYES. I never want to see eyes like that again. I did, however, see them once in the mirror.

*Tell me what it costs for me to be there. Don't tell me not to worry about it. That's what I do. I worry. In the words of my first shrink, I am a "ruminator." DON'T TALK DOWN TO ME. LOOK AT ME!

*Even though I am on suicide watch and can't go to the cafeteria, can someone make sure I get a plate? And, no, I can't have the lasagna because I am on an MAOI! (at the time).

*Can I count on you, nurse, to give me the right meds in the right dose, even if they've been chaged. NO? You have to be as aware as you can as a patient.

*Rampant rumors of patients getting assaulted? Of employees hiding in patients rooms to watch them undress? How about some reassurance.

MANIPULATIVE: Word used by lazy and uncreative mental health "professionals" to shame you into towing the line. DON'T FALL FOR IT!

Lily

DrivingMissMolly said...

More:

SYMPTOM THAT BOTHERED ME MORE: I started cutting myself using bobby pins that I had taked the protective tips off of. This started after I was in the hospital. I did not do it before. I falt alone. I didn't even know other people did it until years later when it was on a Dateline special! I hid the cut marks that where up and down my forearms with my sweatshirt. Doc's only comment was that they were ugly and would scar. That was it. I quit on my own about 2 weeks later and stopped cutting myself until another longer phase started about 3 years ago making for a nearly 20 year gap. Again, I stopped on my own.

PROBLEMS WITH OTHERS
At unit meetings the other people on the unit said they wanted me gone. I had used Coke cans and plastic utensils to cut myself and they were sick off all the stuff that got banned to try to keep me from harming myself. People were not sympathetic anymore. There were new patients who didn't know me and they just got on the 'hate Lily' bandwagon.

I WOULD HAVE LISTENED but no one cared enough to sit and talk to me about it, except me and my Teddy bear.

I CAN'T THINK OF ANYTHING HELPFUL ANYONE SAID TO ME.

OTHER PEOPLE
I noticed them but couldn't tell why they were there unless I found out in group that they were alcoholics or there for medication tweaking. The only things I realy noticed was psychotic behavior and dry scaly hands from excessive washing, and there was this girl who shook, shook, shook and never talked.

Lily

Anonymous said...

1. I was terrified, and all I wanted was some human comfort. I had been committed while I was unconscious based on a rumor of family mental illness. My 'symptoms' were crying, and being really withdrawn because all of a sudden I was in a strange place where people were talking to me as if I were a mentally retarded child.

2. As far as I can tell, the only people who were bothered by my 'symptoms' were the staff members at the hospital. If crying is a symptom. They responded by giving me more powerful medication, since crying is such a dangerous thing. I was left feeling numb and even more disconnected.

3. If anyone had taken the time to honestly talk to me, I would have responded. The problem is I was committed before anyone talked to me. Once the involuntary commitment is in place, it is not safe to talk. Anything I might say might be used against me to extend the commitment. The only talk I received from the hospital staff was straight out of the DSM...'do you see patterns in things'. Yes, I see patterns...I see patterns of diamonds in the cloth. I see patterns of behavior. I see patterns all over in the world. Seeing patterns, in and of itself does NOT mean one is mentally ill. Doctors who are excellent diagnosticians also see patterns.

4. A family member told me to 'go along' with the treatment, even though I knew the medication was harmful. It allowed me to get out of the hospital as quickly as possible.

5. After I got over my initial terror, I started to connect with my fellow patients. I found just the act of talking to them about something they loved brought tears to their eyes. I tried to make their stay a little more 'human', since I hated being treated like a non-human by the staff.

Anonymous said...

1. My most dangerous symptom was not seeing a reason to live. There was nothing that could convince me life was an option. I believed God wanted me dead, that God wanted me to kill myself. At the time it wasn't bothersome, because it was just true. Looking back, obviously that was awful. At the time my worst symptom was feeling the need to hurt myself, with whatever I could get at. How did I deal with them? By trying to kill and hurt myself, even on the unit.

2. How could I tell when my problems were causing problems to others - when I was involuntarily hospitalized, or my parents cried.

3.If someone told you that you were doing something unusual or bothersome, would you have listened when you were sick? Yes, but I may not have believed it was a problem. They didn't understand that God wanted me to do it. And no, I wasn't hearing voices. I was using logic.

4.What was the most helpful thing someone said or did to help you get by when you were ill? My therapist suggested I go to grad school. Honestly! I was pretty sick still, but it gave me a goal. I managed to get a master's degree, get off meds and out of therapy, simply because someone had hope. By being in school, I also had access to a great psychiatrist and good health care.

5.When you were on the inpatient unit, did you notice other people's symptoms? How did you deal with them? Yeah. I humored them. I was kind. I found patients that were more like me and spent time talking to them.

Unknown said...

when I was under a behavioral hold
I had a glucose score of 193.

I found out months later, that I'm prediabetic.

Wouldn't it have been in my best interest to share the info. with me while I was in the hospital psych.

I had internist test me later for fasting glucose and I came up prediabetic.

I'm wondering why psychiatrist that released me did not info me
about my test?

thanks,

Karen