Sunday, July 7, 2019

My Night in the Psych Unit Part 2

***Trigger Warnings*** This post discusses self-injury, cutting, suicidal ideation, and time spent in a psychiatric unit, reader beware

Disclaimer from yesterday's post:


[As mention in previous blog (link here), I had an experience with my OCD and OCD meds in 2014 that led to my spending one night in the psych unit at Yale-New Haven Hospital in New Haven, CT. Before I begin this story, I want to acknowledge that my experience is personal and I do not intend to generalize the experiences of individuals who may also have spent time in a locked unit due to mental illness. I also want to recognize that this post may be triggering to those who have personal experiences, direct or indirect with mental illness, psychiatriac hospitals, and involuntary commitments. I want to make clear that I sought treatment myself and made a conscious decision to spend the night in the psych unit because I felt I was a threat to myself. Working in the mental health field for several years, I know that my experience was more independent and person-driven than others' experiences and I want to acknowledge how unique my experience was. That being said, let's start at the beginning.]
 
 
I wrote down my uncle's phone number since I knew my phone would be confiscated and told him I would call when I was discharged. He hugged me and I held back tears, trying to put on a brave face. I headed to the locked psych unit, a place I had referred so many clients and families before and even called EMS for actively suicidal clients in session. Two officers escorted me to the locked unit and asked if I had ever been through this before. I answered, sheepishly, "No, but I'm a therapist, so I think I somewhat know the drill." They confiscated my phone, hoodie (because of the drawstrings), and my shoes. I was given hospital slipper socks with grips on the bottom and a stack of magazines. The psych unit was so crowded that evening, I was sequestered to a stretcher in the hallway. My leg cuts at this point had dried over the cut up sock I used as a makeshift bandage before I left my grandmother's house. I asked several times for someone to give me supplies to clean my cuts, but it took hours before someone came to cut the blood-dried sock-bandage off my legs and clean me up. I knew I didn't need stitches. 
 
 
 
My cutting was rarely deep, but always sporadic and spastic. I cut fast and non-discriminately, although somewhat discriminate since I only cut places that would be easy to cover up. For me, cutting was more about the pain after. The cutting itself was a means to an end. Cutting was a punishment. Days and sometimes weeks later, my cuts would still ache. I cut myself the most when I was a daycare teacher, because I was in a very abusive and controlling relationship, living hours from my family without a vehicle. When I cut my thighs, days later I would squat down to tend to one of my toddlers and I would feel the sharp, burning sting of the cut stretching over my thigh. It was a painful reminder that I deserved to feel hurt and punished.
 
 
 
While I waited, the hours ticked by. I estimated I arrived at the hospital around 6pm and by 11pm, I still hadn't been evaluated by a doctor. There was a young man, maybe around 19 or 20 years old, in a bay with a closed curtain. He was talking and laughing and screaming, carrying on whole conversations for which I was only hearing one side-the side being in his mind. A nurse checked on him often and the young man asked to leave. The nurse informed him his family was concerned about him and he was on a mandatory 72 hour hold (in North Carolina we call that an IVC-involuntary commitment). The nurse informed him he had threatened to harm his grandmother and then himself. The nurse spoke with familiarity and I imagined she knew this patient well. Overhearing this encounter made me feel selfish and privileged to have chosen to come to the hospital. Was this a pathetic excuse to escape my responsibilities? Was I really a threat to myself? Why was I here? The thought You're not crazy if you're afraid you're crazy kept repeating. 
 
 
 
I hadn't emoted in any way, shape or form for hours. I absentmindedly leafed through magazines. After midnight, a doctor finally spoke to me and asked me why I was there. I told him about the self-injury and the fear of hurting myself again. In a monotonous tone I stated "I'm afraid the children I counsel are going to die and if they do, I'll kill myself." The doctor stated he wanted me to move to the crisis unit for the night and be reevaluated in the morning. Even though there was nothing physically wrong with me, I was transported by wheelchair down several hallways and rode on a number of elevators. I remember laying in the room I shared with another individual in a psych crisis and wondering How did I get here...how did it come to this? My dog, Chrissy, had died the previous year and from time to time I would swear I could feel her physical presence on the bed with me, typically at times I was distraught. I hadn't felt her presence in a while, although looking back it's possible her spirit tried, but I was too numbed with alcohol and food to feel it. That night, I promise you, I felt Chrissy's spirit on the hospital bed with me. I felt her body snuggled against my back in the same way she did when she was alive. I felt her warmth and I felt comforted. 
 
 
 
I drifted off to sleep and when I woke up, I ate breakfast that was delivered to my room. I hadn't had my medication yet, because, as the nurse reported, "I think the doctor is going to make some changes." Mid-morning I wandered down the hallway to what appeared to be a vacant conference room and found some coloring pages and broken crayons. I busied myself with that for a while until the doctor was ready to speak with me. The mere question, "So, what's going on?" was all I needed to completely break down for the first time not only since I had been in the hospital, but in months. I began sobbing as I explained the unreasonable demands of my job, my anxiety over something happening to my students, my decision to kill myself should something irreparable happen to them. I cried so hard I hyperventilated as if I was remembering how to cry. The doctor was very kind and compassionate, although stated the obvious "You can't keep on like this, you'e too hard on yourself, you're putting too much pressure on yourself" all the things I have heard my entire life. But, for some reason, it resonated with me that morning. I was expecting and hoping for the doctor to write me a letter saying I couldn't return to work-ever. I was looking for someone else to take on the responsibility of making that decision for me. 
 
 
 
After I let out everything I had held in for months, I immediately became aware and knew what I needed to do. Being a problem-solver has always come easy to me and in an instant I knew what I had to do. The doctor cleared me to go home and increased my Prozac to 80 mg daily. I called my uncle and he stated he would be able to pick me up after 3pm. I ate lunch in the hospital bed and napped some more until it was time to leave. With a clear head, I asked my uncle if I could spend the next couple nights at his house, understanding part of my depression and anxiety was the living environment I was in. I also called my boss (my mother had called him earlier that morning and told him I was in the hospital with stomach pain at my request) and asked if we could meet on Monday so I could discuss with him what's going on with me. He was supportive and obliging. I took two weeks off and shared with my boss (in so many words) that I was having serious mental health reactions to the work load and I needed to take all the PTO I had saved, effective immediately. I also advocated and stated before I returned to work, I needed to return with help. That the job I was doing was unmanageable for one person. Interestingly enough, it took less than 2 weeks to find additional help, even though I had been asking for 4 months.
 
 

Saturday, July 6, 2019

My Night in the Psych Unit Part 1


***Trigger Warnings*** This post discusses self-injury, cutting, suicidal ideation, and time spent in a psychiatric unit, reader beware

As mention in previous blog, I had an experience with my OCD and OCD meds in 2014 that led to my spending one night in the psych unit at Yale-New Haven Hospital in New Haven, CT. Before I begin this story, I want to acknowledge that my experience is personal and I do not intend to generalize the experiences of individuals who may also have spent time in a locked unit due to mental illness. I also want to recognize that this post may be triggering to those who have personal experiences, direct or indirect with mental illness, psychiatriac hospitals, and involuntary commitments. I want to make clear that I sought treatment myself and made a conscious decision to spend the night in the psych unit because I felt I was a threat to myself. Working in the mental health field for several years, I know that my experience was more independent and person-driven than others' experiences and I want to acknowledge how unique my experience was. That being said, let's start at the beginning. 
 

 
I mentioned in my previous post, that I was officially diagnosed with OCD in 2012 and was treated with Prozac. By Fall 2013, I was on 60 mg of Prozac a day, but also going through a break up, moving back in with my grandmother (with whom I had/have a contentious relationship), and transitioning to working full time as a school counselor in Bridgeport, CT for two Catholic schools. By November 2013, I already felt I was drowning and attempted to be proactive and inform my clinical supervisor. Because I worked in a depressed area with little funds, I was informed there wasn't enough money in the budget to hire the extra counselors I needed to help offset the weekly influx of new students I was assessing for high risk situations, including domestic violence, child abuse/neglect, suicidal ideation, and self-injury. Each week, I was flooded with dozens more students to meet with and assess, all of whom would qualify as high risk and all of whom I was supposed to be coordinating with the Catholic Charities clinic for follow up therapy. Herein lies the problem, the majority of my students were Latinx and Carribbean, two cultures that historically do not feel comfortable seeking counseling, especially not for their children for fear of Department of Children & Families (DCF) involvement, as well as Immigration. In addition, most of the families did not have the means or ability to drive their kids to and from counseling several days a week. It was more convenient and most trusted for the children to see me in their school. So, that's what I did. To my own demise.
 
 

By Christmas break, I was more than burnt out. I was drinking a bottle of wine and binge eating daily all in an effort to fall alseep and escape reality. I would sleep until 2pm on the weekends, eat "breakfast" and go back to sleep. I dreaded work, but worse than that, I dreaded not being at work as I began to feel overly responsible for everyone's well-being and safety. The Friday before Christmas break, I had barely walked in my front door when the prinicipal of the school called to say I should check my work voicemail. An irate parent had left a threatening message in regards to my reporting her actions THAT SHE REPORTED TO ME to DCF. In this voicemail, she threatened to kill me so I felt compelled to save the voice message. Somehow, I still felt "okay" and "in control" of the mounting pressure and debilitating stress. When I returned from Christmas break, I was met with the same unreasonable demands, high risks check ins, and no aid from the mental health clinic I was contracted through. My cancelling weekly supervision with my clinical director due to the overwhelm of high risk families and children should have been an indicator I was drowning. That and the fact that I was actually drowning!
 
 

The following 2 months after returning from Christmas break, things went from bad to worse. I was often at the school from 6:30am to 5pm facilitating calls to DCF and STILL making mandated reporter calls on my hour-long commute home. While this didn't happen everyday, it happened often enough that I was beginning to unravel mentally. In the past, I had struggled with self-harm and I was beginning to have thoughts of self-harm again, for the first time in years. I was on 60 mg a day of Prozac, but often felt emotionally muted and commented that I was unable to emote appropriately to the stress that was happening to me. I was numbing myself with medication, food, and alcohol. 



By February 2014, my only escape was sleeping. I slept all weekend and my grandmother didn't understand or approve of my sleeping the weekend away. Even though I was 32 years old, working full time (and then some), paying rent, and attending to all my other adult responsibilities, my grandmother would come into my room (her reason for "barging in" was "it's my house, so this is my room") and demand I get up. Her reason? "I don't like it. I don't like that you sleep all day." My response was: "I'm depressed." But, after some time, sleep wasn't an escape any longer and the tiny "office" I shared with the school nurse, that wasn't heated (in February...in Connecticut) seemed to be getting smaller and smaller. My world was closing in around me. Everyday, my kids (students) were having crises and I was only one person and I couldn't fix everything. I was constantly afraid of my 8th grade girls killing themselves or my 6th grade boys assaulting another student and somehow it would be: ALL MY FAULT. 
 
 

"All my fault" is classic OCD symptomology. Feeling the full weight of real or perceived responsibility is a crushing obsession to hold onto everyday. Even more crushing is asking for help and being told "there is none." Thinking about something traumatic or tragic happening to one of my students "under my watch" made me so anxious and depressed, I began to concede to this thought: "If one of my student's kills themselves, I'll kill myself. I won't be able to live with myself. So I'll go too." Once that thought became an option, it was somewhat easier to push on. 

On Wednesday February 26, 2014 I started the day like "normal", binging on Dunkin Donuts and coffee while listening to NPR on my way into work. I was still exhausted from the previous day and already exhausted from my upcoming day. Around 7:30am, one of my 8th grade girls came in with a crisis. She had been harming herself. More specifically cutting herself. Instantly I was triggered. I remember thinking "I'm going to cut myself when I get home today. I want to die." I barely held it together the remainder of the work day. I wrote my hours and hours of notes (by hand). I got in my car. I drove home, silent tears streaking my face, numb and powerless. I walked into the house and cut my legs up. I don't want to go too into detail about the self-injury itself because it can still be triggering for me, but I knew I wanted to do more and I knew I wouldn't be able to stop myself. And I scared myself bad. I called my uncle and calmly stated "I cut myself and I need to go to the hospital." He instinctively knew the cut was self-inflicted because when I climbed into his huge pick up truck, he said "Yale Psych?" and I replied "Yeah."

I approached the check in counter and stated "I cut myself. On purpose. And I feel like I'm going to do it again."