Thursday, July 30, 2015

The Unbearable Burden of Mental Illness

As I sat on my couch that hot July morning, I cried.

I cried for so many reasons that I cannot put them into words. My body hurt. My chest hurt. My insides hurt. My heart hurt. And there was nothing I could do to stop it. For fifteen years I have carried this burden on my shoulders. Depression. Anxiety. Panic disorder. Chronic insomnia. And now, physical pain. At only thirty years old, my lower back had become a pile of crumbling muscle instead of the thing that supported me. Every morning when I'd wake up, the pain started.

I'd turn over, spasm.

I'd turn back, spasm.

I'd try to sit, spasm.

I'd stand up, spasm.

It was an endless cycle, an unbearable burden that my body could no longer support itself, and I was too anxious to get help. Too afraid to ask, even my closest friends, my family, my fiance.

I did not want to burden them.

I'd lie to my doctor and tell him I was fine. Tell him that the medicine was working, but it wasn't. I still felt depressed. And anxious. And scared.

And suicidal.

A lot of people believe that suicide is selfish. But it's always the people who have never been suicidal before who believe this. When a person is suicidal, they believe they are a burden on everyone around them, and dying would make everyone's life easier. You believe your loved ones, your friend, family, children, all of them, would be better off with you. And I can promise you there is nothing worse than truly believing your own child would be better off with you.

I felt too much all at once. Emotionally and physically, and I couldn't take it anymore. For fifteen years, I've tried to get better with medications, counseling, hospital stints, CBT, anything and everything I could think of, and nothing was helping me, and I didn't understand why. Was there something innately wrong with me to where I was unable to heal? Was my brain too far gone from all the medications and trauma to ever get better?

WHY wasn't I getting better?

When my lower back got bad enough, I'd go to my Primary Care provider and get muscle relaxers and narcotics. Until I was told I was “over using them.” And even though I was taking them as prescribed, and I believed my doctor understood how much pain I was in, that was the day I realized I couldn't take them anymore.

So it was time I learned live with the pain.

This is what I get for asking for help.

~*~

There were days where I'd lay in bed and cry, wishing I would die. Every night before falling asleep, I prayed to the universe I wouldn't wake up the next day.

But I always did.

My son came into my bedroom as I cried and hug me so tight, with his bright, beautiful smile and he'd say, “I love you, Mom.” And I smiled back and said, “I love you, too. More than anything in the whole universe.”

That is not a lie.

Which is why, on that hot July morning, I decided I needed to do one of two things; kill myself, or get help.

And I chose the latter.

~*~

I arrived at the Emergency Dept. with my mother around 4:30 pm that Monday evening. The place was packed. It's a fairly large waiting area, and there wasn't a single chair open for us to sit. But that was not the ED I had come in for.

When it was my turn, the nurse called me up to the window and asked to verify my information. Name, birth date, address, phone number, emergency contact, etc.

Then the doctor came in and said, “What brings you in today?”

I replied, “Oh, the usual. I want to die.”

The nurse took my blood pressure, which was abnormally high, along with my pulse and temperature. After given a wrist band with my name and a bar code, I was taken to the Psychiatric Emergency Dept waiting area, the place they bring you before actually going upstairs. The Pre Psych ED.

An older, black, drunk man sat in a chair across from me, screaming and swearing at the top of his lungs. He started singing a song about a woman he missed, but never got the chance to know. My mother and I looked at each other. “Well, at least it's always interesting when you come here.”

Around 5 o'clock, a nurse dressed in red scrubs called my name. I raised my hand, like I was a student for some reason, and stood up. She carried a red folder under her arm, and a blue plastic bag.

“I just need to collect your things.” I put my purse inside. She handed me a pair of gray hospital socks.

“I can't wear my flip flops? There aren't any laces.” It wasn't my first time in the ward.

“No, sorry. We're really strict about shoes up there.”

“But why can't she wear flip flops?” My mother asked.

“Well... they can be thrown. And people are less likely to try to run without their shoes.”

Wow, you sure know how to make a girl feel safe...

I put my flip flops in the bag and put on the ugly, and NOT warm or soft, gray hospital socks, that who knows how many other people had worn before me, and we stepped into the elevator. Not only could I not throw my flip flops at anyone who annoyed me (which... really?! I'm depressed, not psychotic) but I was literally not allowed to leave.

Feels just like home.

As we rode up the elevator to the Psych ED, the nurse explained to me the protocol for what would happen when we'd get there. I'd have to speak with 3 separate people, all at separate times. The first being the nurse, the second being an evaluation specialist, and the third is, finally, the doctor. [And I don't mean the fun one with the blue box, who could get me the fuck out of that place.]

The doors opened and we walked down a long corridor with locked rooms, no beds, but couches and chairs. She said we could lay down out here if we wanted quiet, or go in the doors to watch TV. It wasn't horrible, at first. But the chairs were.

The chairs and couches were the most uncomfortable things I've ever sat on, and I've ridden in a big rig trailer and slept in the sleeper cabs. After sitting in a blue plastic chair for 30 minutes before we actually got up to the floor, now I had to try to get comfortable on one of these things? Hard as rocks, not long enough to lay down, and paper thin white blankets.

My back began to throb.

When I had my son ten years prior, I had all back labor. I felt nothing in my stomach. The pain I felt in my lower back on this night felt especially similar to that.

After another hour of sitting, standing, laying down, pacing, and sitting again, I spoke with the receptionist. Or orderly. Or maybe she was a nurse of some kind. She had long dirty blonde hair worn in two braids with a head band, glasses, and wore puke green scrubs. I asked her how long it would be before I finally spoke to someone. She told me she couldn't give me a time frame. There were five people ahead of me, and all of us came up around the same time. So, I asked, “Well, how long will I be stuck in the ED?”

She said, “Probably all night.”

This is what I get for asking for help.

Another hour goes by and I am finally called back by the nurse interviewer. A male nurse, tall, with glasses and brown, balding hair. He brought me into one of the locked rooms in the hall way with nothing but an ugly orange two seater couch to sit on, that looked about as comfortable as it was, and my back hurt too much to sit.

He asked me about my medical history, even though it was right there on the computer screen he was looking at.

“What medications are you currently taking?”
I told him, even though he was reading the list right in front of him.

“Are you allergic to anything?”
“Yes.” Look at the list.

“Emergency contacts?”
“My mother,” I said, as I pointed out the door. “Who's sitting right out there.”

I paced the room because it hurt too much to do anything else.

“Medical history?”
Are. You. Fucking. Serious?
“Yes, I have one.”
My stars, these people are incompetent idiots. Or maybe just don't know how to READ.

“On a scale of 1-10, what is your current pain level?”
“Nine.”

“What would you normally take at home?”
“What my doctor tells me to take, which right now is the hydrocodone-acetaminophen.”

“Okay, I'll write it up and send it to the pharmacy.”

I went back to the waiting room and sat with my mother, paced the floor, attempted to lie on a couch, for another hour before he returned with three Ibuprofen.

“I'm confused, why are you giving me this?”

“That's what was approved.”

A tidal wave of anger ripped though me. The pain in my back was not something you can take ibuprofen for. If it were, I would have asked for it. I dug my nails into my arm, scratching and pushing until the pain in my arm was worse than the pain in my back.

It worked. Something finally worked. My back stopped hurting.

I know it's really unhealthy to self injure.  I used to do it in my late teens and early twenties, but it was the only thing I could think to do, that didn't require me punching the nurse in the face.

Tears streamed down my face as my mother brought the nurse back over and he asked me why I was doing what was doing. I told him, “I just need the pain to stop.”

“Well, I can only give you ibuprofen. Your doctor made a note in your medical records that he's 'concerned you're using too much Hydrocodone.'”

My mother and I : “What?!”

My doctor has never once mentioned this to me. He has never expressed any kind of concern, and has always refilled the medication when I've asked.

But I guess asking for pain medication automatically makes you a “drug seeker.”

“I don't understand. He's never said anything to me about this before.”

My mother, my hero, “Did he really write that, or are you just making that up?”

The nurse started shaking nervously and took a minute to respond, “... He really wrote that.”

{To clarify: no, my PCP did not write that. Because when I got home, the next day, I asked my Primary Care Doctor if he wrote any such note in my chart, or medical records, and he said, and I quote verbatim, “I did not put this in any recent notes...”}

So, why did the nurse just lie to me?

If the hospital didn't want to, or feel comfortable, giving me a narcotic, then fine. But there is no reason to lie to me about it, and make me feel like they think I'm a drug seeker, when I already have anxiety disorder. Now, I'm officially paranoid. I have enough problems in my life, the last thing I need is to be labeled “a drug seeker.” I am an intelligent, college educated woman, who has a child. And I can promise you, him, and anyone who asks, I would never do anything to risk losing him.

The people in this department do not know me. This nurse has never met me before in my entire life, and now he assumes something that is untrue.

“Well, you didn't come to the hospital for pain.” … On top of being a condescending asshole.
No, I came here to get help because I WANT TO DIE. “I know that, but I didn't know my back was going to flare up when I got here.”

“This has been an on going problem, correct?”
“Yes, I have lower back problems. It comes and goes. It's not an all-the-time thing.”

“But you've been walking around the waiting room the entire time you've been here.”
“That's because it hurts too much to sit, or lay down on these horrible couches! I cannot get comfortable!”

Apparently, being able to walk means my back doesn't really hurt.

“Okay, okay.”
“I'm incredibly uncomfortable. I'm in pain. I have a lumbar sprain from moving {we'd recently moved a few weeks prior, and my back wasn't getting any better} and I have a prescription for this medication.”

“Okay, okay,” Micheal, the “nurse”, said. “But your doctor only gives you a few days at a time.”
“I know that. What difference does that make?”

He said nothing, and walked away.

I looked down at the red marks and broken skin on my arm, not bleeding, but enough to sting for a few hours. Enough to make the pain in my back go away.

After a few minutes, I stood up again and began to pace the waiting area. I noticed a sign on the wall across from me, lamented, but printed from a computer, and taped to the wall. It read; “Please let us know if there is anything we can do to make your stay more comfortable. We are here to help and serve you in anyway we can. Our patients comfort and safety is our first priority.”

This is what I get for asking for help.

~*~

2:26 am rolled around and I still hadn't seen the evaluation specialist. I'm getting antsy, feeling like I did something wrong by asking for help, and no longer wanted to be there. The walls were starting to close in around me, and my anxiety was getting worse by the minute. There were no widows to the outside world in this department, and I felt like I couldn't breathe. It was obvious I made the wrong decision by coming here, especially after the way I was just treated.

There was, however, a pane of windows that separated us crazies from the nurses, doctors, orderlies, and secretaries. There was a sliding Plexiglas window you needed them to open in order to speak to someone. I was pacing the hallway when the window slid open.

“I bet you $20 bucks that girl is just an attention seeker.”

I looked up, and three of the scrub dressed employees stared at me with a sparkle of laughter in there eyes.


... Salt in the wound like you're laughing right at me.

 This is what I get for asking for help.

~*~

3 am

I am finally called back to speak with the evaluation specialist.

“So, what brought you in here today?”
 I want to die. “Well, honestly, I think I was just having a bad day, and made a rash decision.”

“So, are you feeling like you want to die right now?”
 Yes. “No.”

“Do you ever go to bed wishing you wouldn't wake up?”
 Yes. “No.”

“Have you felt suicidal over the past 30 days?”
 Yes. “No.”

“Have you ever attempted suicide?”
 Yes. “No.”

“Do you feel safe at home?”
 No. “Yes.”

“Do you feel you have a strong support system?”
 No. “Yes.”

“Can you list for me three positive things about yourself?”
 No. “I'm a good mother. I'm funny/sarcastic. And... creative.”

My stars, the level of bullshit I can come up with even amazes me!

“Did you have a plan on how you were going to kill yourself?”
 Yes. “No.”

“Okay, we're all set. I'll talk to the Doctor and see if we can get you out of here.”
I smile the best fake smile I can muster, “Thanks.”

This is what I get for asking for help.

~*~

3:30 am

Doctor Contreras called me back into the interview room. He asked me the same questions the evaluation specialist did, to confirm that my answers were the same.

“So, what brought you in here today?” He spoke so quietly, I could barely heard him.
I want to die. “I was just having a bad day, and made a rash decision.”

“Did you want to kill or injure yourself?” He mumbled, incoherently. But since I had just been asked the same question, I understood.
Yes. “No. I didn't want to die, I just … needed everything to stop. I felt like I couldn't breathe.”

“So, are you feeling like you want to die right now?”
 SPEAK UP! Yes. “No.”

“Have you felt suicidal over the past 30 days?” MUMBLE MUMBLE MUMBLE.
 Yes. “No.”

“Do you want to physically harm anyone else?” or “D...w...p..ha..an..se?”
 Are you fucking kidding me? 
 Yes. “No.”

“Do you ever not sleep, but feel like you have more energy, or are“wired”, regardless of sleep loss?”
 Huh??
 Yes. “No.”

“Do you have times when your mood 'cycles'? That is, do you experience 'ups' as well as depressive episodes?”
I slid my body closer and turned my ear toward him, “Can you repeat that?”
“Mumble, mumble, mumble, repeat.”
 Yes. “No.”

“Any appetite loss or gain?”
 Yes. “No.”

“Are there times when you're more talkative or speak much faster than usual?”
 Yes. “No.”

“Are you easily irritated?”
 YES! “No.”

“Have there been times when you've felt both happy and depressed at the same time?”
 Yes. “No.”

“Have you ever been, for no apparent reason, been VERY angry or hostile?”
 Yes. “No.”

“Have you ever had periods of tearfulness and crying, and other times laugh and joke excessively?”
I swear he's reading these straight out of a text book. 
Yes. “No.”

“Do you feel safe to go home tonight?”
 No. “Yes.”

“Do you have any other questions for me?”
Yes. Why the fuck can't you SPEAK UP SO I CAN HEAR YOU?! “No.”

“Okay, well, I think you're okay to go home, so I'll go get your discharge papers ready and have someone get your stuff.”

~*~

Only a few minutes go by before I am handed my thing and my discharge papers, but it felt longer. It was almost 4 o'clock in the morning, I was exhausted, my mother was falling asleep on a couch with no pillow or blanket, and after spending that much time in the Psych ED waiting room in uncomfortable chairs, feeling like no one really wanted to help me, it felt like a lot longer.

There were maybe 5-8 other people in the ED at the time (I didn't count...) and I was the only one who was never asked if I wanted a drink, something to eat, a blanket, etc. My mother had to ask the nurse for a blanket for me. However, the pig-tailed glasses girl did bring me a pillow about 30 minutes before I was discharged...

It was the evaluation specialist, who also happen to be a female nurse, who discharged me. She had short dark hair and eyes, but a kind smile. Out of everyone in the department that night, I think she was the only one who treated me like an actual person, and not a joke.

My instructions were to follow up with my PCP and go to my County Mental Health Center to get a counselor, and talk about getting new medication, or upping my current medications. But I already knew this. It was why I came to the hospital in the first place; I needed different medication, ones that don't make me depressed or suicidal.

She unlocked the doors and let us leave, with my shoes on and purse across my shoulders.

And I felt exactly the same as I did when I first entered the hospital.

This is what I get for asking for help. 

And why I will never ask for help again.