Friday, September 26, 2014

Emptying my bag

I was alone in the back seat of my mother's van.  The pills I had ingested were taking effect.  I had my phone in my hand and I was trying to text my friends to tell them that I was going to be gone for a few days and that my stepdad's driving was going to kill us.  I could feel myself slipping in and out of consciousness in that seat and it was the best feeling in the world. The troubling part was the time in-between bouts of consciousness.  There was nothing, only Darkness.  No dreams, memories, family members to greet me, nothing.   It was not anything like what I had seen on tv when someone described a near-death experience. 

I remember pulling into the ER parking lot and my mom going into the hospital to tell them I was there.  I don't remember how I got from the car to the ER, but I remember telling my mom to go home, that I didn't need her there.  Surprisingly, she left.  Then, again, darkness.  Black.  Nothing.  I heard the doctor tell me that he was going to put oxygen on me and that I needed to breathe.  He told me I wasn't breathing and he was trying to coax me into consciousness.  The doctor faded out into the darkness as well.  The next time I opened my eyes, there was a social worker asking me questions.  I was angry with her and had no idea how to even answer the questions.  I don't remember what I said to her, but it must have been interesting, as the next morning I sneaked a peak at my assessment and saw I had been diagnosed with psychosis NOS.  She reported that I was hallucinating.  I don't remember any of that.

The next time I saw light and came out of the darkness for good was getting off the elevator on the mental health unit at the hospital.  At the nurse's station, one of my good friends and former co-workers greeted me and informed me that he would not be working in that unit while I was there, trying to make me feel more comfortable.  As a person with a masters degree in social work and years of experience working in the field of mental health who was now, herself, a patient in the "nut hut," feeling comfortable wasn't an option for me.

I spent the remainder of those early morning hours in a room designed for caring for people who were depressed and suicidal.  There were no cords or sharp objects, no television or radio, just a bed stripped down to the bare essentials, a small bookcase with a bible on a shelf, and a bathroom with a door that swung open and shut with no latch, lest I get in there and try to off myself with the toilet paper.

Four months prior to this night, I thought life was as bad as it could get.  I had lost my house to foreclosure and my husband to his alcoholic lifestyle.  I was single with five kids.  I spent my days tying knots in ropes trying to keep hanging on to my life and sanity.  I was working as a therapist for a company I hated.  My friends were non-existant or at least out of reach.  I had met a man I thought was going to solve all my problems, and he left for a job in another state.  The night I took the pills, I had just snooped in his email and found he had been emailing other women before he even got out of state.   I didn't initally intend to overdose, and I missed every single one of my own warning signs.  I gave most of my stuff to my daughter and friends.  Since I couldn't sleep in my king size bed or in my room, I gave my big bedroom to my two little ones. I took one of their twin mattresses and put it on the floor in the smallest bedroom we had and called it my bed. I had been taking medication for sleep and anxiety for years, but they no longer seemed to be helping.  My doctor started me on a new atypical antipsychotic to help with mood stabilization and it seemed to be making things worse. 

Trying to stop the tremors from the new meds and calm myself down to sleep, I took some anxiety meds.  I started out at a normal dose, then added a little more for good measure.  Then I took some pain killers I had on hand to help me sleep.  Sleep was still elusive, so I took another anti-anxiety pill.  They just did not seem to be working.  When I got to the point where I couldn't remember how many of what pills I had taken, I called my mom and told her I needed to go to the hospital.  I refused to go to our local ER and insisted on going to the ER at a hospital over an hour away, where they had a mental health unit.  I think I knew I had made a half-hearted suicide attempt and needed help.  Stumbling through the house trying to put shoes on, I felt the first twinge of fear about what was going to happen to me.

As is normal for most people after a botched suicide attempt, I felt really stupid the next day.  Many times while working on the mental health unit at another hospital, I listened to stories of people who had thought they had reached the end and attempted suicide only to wake up and feel like jackasses.  I was no exception.  In that moment, life seems to be impossible, the pain insurmountable, and getting out is the only viable choice.  Given a few hours, those feelings often pass, especially once locked in a mental health unit where shoelaces aren't even allowed due to the danger of someone hanging themselves with them. 

My mission on that first day on the unit was to convince the doctor I needed to go home.  I wasn't suicidal, it was all a misunderstanding and I didn't need to be there with the crazy people.  I was perfectly sane.  Taking too many pills is a perfectly normal reaction to my life at that point, and I needed to get home to remedicate myself.  After all, I knew they were going to cut me off the meds that "really worked," (aka the meds that made me numb) and put me on something stupid.  Didn't matter what they said, I knew myself better, knew what worked, had a top-notch psychiatrist out in the community, and was going to do as I damned well pleased anyway. 

I "met" my doctor that first day.  She was a psychiatrist at the place where I worked at the time, so that was totally embarassing.  I called in to work and told my boss that I was in the hospital but gave no more details except that I would not have access to a phone.  The scheming for release continued but my doctor would not budge.  She was convinced I was a danger to myself and told me that if I tried to leave, I would have a 96 hour hold in place to keep me there at least 96 hours.  I knew that any judge would approve that hold, given that I had almost died due to what appeared to be a planned overdose. 

I was aware of the game I needed to play in order to be set free: go to groups, stay out of bed, play nicely with others and put a smile on your face.  I happened to befriend another patient on the unit pretty quickly.  She looked "normal" like me.  Having worked in the field of mental health for 10 years, I understand the stigma of mental illness and learned not to judge people for being on a mental health unit.  Professionally, that was possible.  Personally, I did not want to be seen as one of THOSE people.  So, the "normal" friend was important for me to have.  She seemed depressed but was functional.  The unit was full of truly mentally ill people, people with schizophrenia who were hallucinating and delusional and people who were otherwise functionally impaired.  My new friend and I walked the halls together and talked and worked on jigsaw puzzles when we weren't in one of those "art therapy" groups where we learned how to express ourselves with markers and dull crayons.  I told her all about why I was there, the "accidental" overdose of pills and the subsequent loss of consciousness.

During a particularly intense jigsaw therapy session, my new friend informed me that she knew why I was there.  I said, "Of course you do.  I told you."

"No.  I know why you are really here.  I don't believe what you told me.  If you had taken all of those pills, you would be dead."
 
I delicately continued my search for a matching puzzle piece, trying to avoid eye contact, and asked her why she thought I was there. 

"You're here because THEY want you to be here.  You're here to spy on me and tell them what I'm doing.  It's not going to work, you know."

Well damn.  Double damn.  Now I am alone in a room with someone who is not so obviously delusional and believes I am spying on her.  We were in a corner of the room furthest from the door and not a staff person in sight. 

Shifting in my chair, I said, "No way.  I'm here because I am sick.  I am sick and I took pills to kill myself."

"I know you are lying."

"Well, I'm tired.  Just beat."  Using the adolescent yawn move employed by teenage boys in a movie theater to get closer to their dates, I slipped out of my chair, pushed it in to the table and headed for the door.  "Just really tired.  Have a good night!"

Whew, I made it out alive and unscathed physically.  I found the nearest nurse and pulled her into my room and informed her that lady is CRAZY.  I explained what happened to the nurse.  Sometime later, I heard yelling and sobbing coming from the woman's hospital room.  I heard discussion at the nurse's station about a "5/2/1" injection, which is 5 milligrams of Haldol, 2 of cogentin and 1 of ativan, typically used to calm down a patient who is escalating into hysteria or violence.  At supper that night, she looked disshevelled and had that chemically restrained look all too familiar to me from my days working an inpatient psych unit.  I was ready to go.

The next couple of days I spent again reassuring my doctor I was "good to go."  I put all my effort into looking happy and well-adjusted so I could go home.  I spent a lot of time on the phone convincing my friends and family I was fine.  I talked to my husband, who was living separately at the time.  I had to have someone to go home to.  The single mother life was killing me and quite honestly, I didn't trust myself at home alone with the kids, although I wouldn't admit that.  My nights were spent lying awake in bed suffering from withdrawals from the lack of anxiety and sleep medication I had become dependent upon.  I spent most of the night tossing and turning and making numerous trips to the nurse's station trying to get medication so I could sleep. 

After much reassuring and begging my doctor and my family to let me out, I was finally ready to go home.  The final factor in my release was the appearance of a former therapy client of mine on the mental health unit.  Appealing to my doctor using the "imagine being in my shoes as a mental health professional" tactic, I successfully won my ticket home.  The last obstacle to tackle was the family session with my husband and the social worker.  Of course I knew how to successfully manipulate that situation to my advantage, and I did.  I left with Mike to go home.

I don't think I had made it out of town yet when I had my anxiety medicine within the palm of my hand and subsequently sliding down my throat in a frantic gulp followed by soda.  I was having full-blown benzodiazepine withdrawals and only had a couple of pills left for the upcoming weekend.  I ended up going to the local ER that night and got a shot of valium because I was beginning to go into seizures from the withdrawals.  I gave the emergency staff the phone number of a friend of mine who was a psychiatrist so that he could order some medication for me, which he did. 

Life eventually got back to normal.  I went back to work where I would run into the doctor from the hospital on my way to the bathroom from time to time.  I know she recognized me, but never said anything to me.  That did not stop my embarassment and shame from engulfing me.  It was a constant reminder that I was not fine. 

I'm not sure exactly why I decided to tell this story.  This was not the first nor the last episode of hospitalization for me.  After this particular stay in the hospital, I began to grasp that I was not in control of my mental illness, it was controlling me.  I also realized I was an addict, a fact I did not deal with for another three to four years.  This is actually my first public admission that I am an addict.  I believe I am probably at the point in my life where I am strong enough to deal with all of this garbage I have been carrying around with me.  The program director of one of the substance abuse treatment facilities where I worked had this great therapeutic tool I think about often.  We called it the "Shit Bag."  We would take clients into group therapy and give them a plastic bag and tie it around their waist.  We would then fill the bag up with a lot of lightweight objects, papers and such, to represent issues in their life they were carrying around with them.  They had to wear the bag and its contents for 24 hours.  They had to eat, sleep and shower with the bag attached.  They also had to journal about their experience while wearing the bag.  The bag inevitably became inexplicably heavy in those 24 hours.  Once they were freed from their tether, the clients discussed in group their understanding of how carrying that bag around was like the resentments, shame and pain we carry around with ourselves every day.  Perhaps this blog entry is about my untying my own shit bag. 

Thanks for helping me empty the bag.