First Time in Inpatient

Well, it’s been longer than expected between posts, and, after what’s been going on over the past 4 weeks, what was planned to be a 2 post series may expand to 4 or 5.

When we left off on my last post, I was riding in a wheelchair, accompanied by a security guard, going to the Behavioral Health Unit (aka: the BHU) in the middle of the night late Tuesday, March 12th. It was far more quiet, and with more lights out than most hospital wards I’d ever been in (even for the middle of the night), though I did see one person in what I later learned was the dining room working on a puzzle. I got checked in, after going through a bunch of paperwork, and shown to my room. Luckily, at least for that first night, I didn’t have a roommate. There was a “skin check” that needed to be done (to check for sores, bruises, etc). Had I cared about, well, anything at this point, I probably would have felt at least somewhat undignified, if not utterly humiliated by the nurses asking me to show, essentially, every inch of skin. As it was, I just wanted to get through it, maybe try to sleep, and then start figuring out what comes next. After the skin check, the nurses helped me settle in as much as I could. They showed me where I could put my stuff, not that I had any. In the ER, they weren’t sure if I could have my own pajamas that my husband had gone home to get, so he took all my belongings home with him. One of the nurses had kindly left a small pitcher of water, and brought me a couple of cups, in case I was thirsty. There was also a bag of basic toiletries in my “closet,” which looked more like an open locker than anything else.

I didn’t sleep too well that first night. First of all, the mattress felt like a cross between a camp mattress and a giant changing pad: it wasn’t very thick and it curved up on the sides, I’m guessing to keep people from rolling out or something. Add to that hospital sheets and pillows, a mysterious dripping sound, routine bed checks (which woke me up even though the nurses were as quiet as they could be), and a ridiculously warm room, not to mention the depression, anxiety, misery, self loathing and my own internal stigma about having to be in an inpatient ward, and it wasn’t a very restful night. I was able to access some of the “resources” I’d been building up in therapy, like letting myself feel my emotions, which led to a not insubstantial bout of crying and, honestly, laying there wishing I just wouldn’t wake up in the morning. There was something fitting about the BHU being in the basement, because, especially that night, the wire reinforced windows, the darkness in my room and outside the window, and the general location of the unit all seemed fitting and reflective of my overall mood and mental & emotional state, and I hated everything about it.

Eventually, morning came, and my day nurse came in to introduce herself. She said that I was scheduled for some blood work, so I needed to do that before breakfast. I made my way down the hall to the lounge near the nurses’ station and got in line. When the phlebotomist asked if I had a preference for my blood draw, I pointed her to where most phlebotomists seem to find a good vein. She proceeded to dig around in my arm for a while and, when she couldn’t get it and I was too uncomfortable, she ended up using a butterfly needle in my hand (and still missed – I had a bruise on my hand for over a week from the 3-ish vials she drew that morning). I’m guessing part of the struggle was likely due to some dehydration, but, at the same time, I’ve had techs find a useable vein and get a blood draw (or even set an IV) when I was even more dehydrated without that much of a struggle or lasting bruise. I suspect some apathy, given the department I was in, may have been in play, if not intentionally, then at least subconsciously.

I grabbed my breakfast, where I noticed that we were only given plastic or paper dishes & cups, with only plastic forks and spoons. I also started observing some of the other patients, who ran the gamut from dressed in relatively normal street clothes and seeming completely average to patients who were still detoxing. Though the treatment was a lot kinder, and the ward was co-ed, bits and pieces of it (like the 3 pay phone-style phones for patient use, and, honestly, a couple of the patients) heavily reminded me of the movie Girl, Interrupted. I didn’t eat too much, though, between the fact that I was one of the last ones to get their tray (so my food was thoroughly cold), and I still didn’t have much of an appetite. I knew, cognitively, though, that I needed food, so I made sure to get some food into my body.

After that first breakfast, I stayed put for the Community Meeting, not because I really cared or wanted to go, but because it was easier than going back to my room. Part of the meeting was making a goal for the day. Not 100% sure what sort of goal to make, I listened to the first couple of people. I realized that “existing” was probably not the sort of goal they were looking for, so I decided to set the bar pretty low for myself. So, my goal that first day was to go to at least 1 group. I figured I could go to one, and sleep the rest of the day. And, in fact, attendance at group was not mandatory. However, my day nurse that day kept (for lack of a better word) pestering me to get up and do things and go to group. She said it would be good for me to stay busy, and, too miserable and apathetic to argue, I went. I did go back to my room to nap after each group that morning, though, generally feeling miserable and sorry for myself. In a way, I was frustrated that I had, in my mind, failed so spectacularly after making such good progress. I was also getting sick and tired of every doctor and nurse and staff member asking me what might have been the triggering event for feeling suicidal, because I didn’t know. As far as I could see, there wasn’t any major, obvious trigger. It just happened, and that’s what pissed me off and scared me so much.

Just before lunch I was in a “Processing” group, where we had space to talk about where we were at, how we were feeling, etc. I remember feeling (and saying) in that group that I really hated knowing as much about my depression as I do, because it felt even more like fighting a constant battle against myself. The whole time I was going through this dark spiral, I knew in some spot in my brain that this wasn’t how I really felt, that I didn’t really want to die, that depression was distorting my thoughts, and yet, because of all of the distorted thinking that was coming from my depression, I couldn’t believe that reality 100%. The social worker running the group validated a lot of what I was saying and asked if I knew about CBT (Cognitive Behavioral Therapy). I am, at least somewhat, since my first therapist and I used some CBT tools to help lay the groundwork for the work that needed to be done. She used it as a jumping off point to go into information on how to recognize distorted thinking, and how that awareness can help build a foundation to re-train our brains, in a way. The words, and even the high level concept seems almost simple, but for those of us with serious cognitive distortions that we fight against on a daily basis, it’s anything but.

As that group was finishing off, though, an older woman, who was dressed well and looked rather out of place on the unit (based on my own assumptions, internal stigmas, and preconceived notions of a “psych ward”) asked if she could share something with me. She told me that, when she decided she needed to check herself in, her son helped her pack a bag. He packed some nicer clothes, and her skincare and makeup, and made her promise to do her makeup every day. She said he told her that, if she did that, then every time she looked in a mirror, she’d feel a little better about herself. So, she said she’d been taking a shower and doing her makeup, and it had been helping a little bit.

I thanked her for that, and headed to the phones to call my husband. I had the rules for what clothes I could have (no underwire bras, no drawstrings, no shoelaces or belts), and really wanted to get out of the ill-fitting hospital gown and scrub pants. The pants weren’t too bad, but, for some reason, the only gowns I was given just barely fit over my arms/across my shoulders comfortably. I was able to keep the front covered, and I used a blanket given to me by the ER as a wrap, but I really wanted to just be a bit more comfortable. Some clean underwear would be appreciated, too, since I only had the pair I’d come in wearing, which I’d had on for over 24 hours straight at this point. As I hung up with him, I mentioned that I’d probably go rest for the half hour or so until lunch, since I hadn’t slept well the night before. Not to mention, it was the only thing I really wanted to do, anyway – keep sleeping with the hope of not waking. Yes, I was still in that dark of a place.

I went back to my room and was about to lay down, when I could hear that woman’s comment about showering and makeup echoing in my ears. I realized I could choose what I wanted “right now” (which, in hindsight, was endorsed by depression), or I could choose something that was a fuller form of self-care. Little did I realize, this choice was a perfect representation of where I was at with my depression and ideation.

What resources do you have available when you’re in a rough place?