This Psych Unit is My Prison

 

I have a lot to say in this post, so it will go on a bit longer than my usual posts. Indeed, I did end up in a psych unit again, this time for 3 weeks, same psych unit as July, same psychiatrist in charge of me. Yes, I do mean in charge of me, but before I get started on that, I’ll provide some of the back story.

I’ve been in psychiatric treatment on and off, mostly on, since 1980. At times treatment was outright abusive, such as strapping me to a bed, often coercive, and usually a process of psychiatrists prescribing this, then that, then stopping that and trying this and adding this and then these, or even insisting I have ECT. My psych hospitalizations total around 60, with 28 of those from 2016-2019 when the psychiatrist had me on up to 8 psych meds at once. And then in August 2019, she stopped 5 meds cold. After recovering from severe withdrawal, I left psychiatric treatment and stopped the remaining 3 drugs. Due to ongoing withdrawal sickness, I stayed mostly isolated at home with my companion cat Iris and the isolation flowed into the pandemic. But I remained free of psych intervention and hospitals. Then two family members died suddenly from heart attacks, and this past June, my dear cat died quickly from aggressive cancer. My pain and despair took over. In July, I self-injured and called 911 which resulted in a psych hospitalization, and though I refused to go back on meds, the psychiatrist agreed to discharge me. His name was Dr. L, and he talked to me for nearly an hour, gaining a full understanding of what I'd been through in psych drug withdrawal, and showing respect for my feelings. Then he left for a week and I was reassigned to Dr. A, who wanted me to stay and start meds again, but deferred to recommendations made originally by Dr. L.

So I was discharged and right away I brought a new cat home named Audrey and was okay for a few weeks, but my sadness and despair over so much led me back to dark thinking. Once again, I self-injured and called 911. And I found myself on the same psych unit, assigned to Dr. A, not allowed to switch to the much better Dr. L (psych units are strict about keeping you with the psychiatrist assigned on admission), and that’s where this account really begins.

My choice was to enter the psych unit voluntarily but that was because a bed became available on this particular unit which has private rooms, a rarity in the area, and if I’d waited for a TDO (temporary detention order) to be processed, I might have been sent to a much worse unit. But I wasn’t happy, especially having Dr. A to deal with again. The first 3 days I scowled and moped around and cursed at the psychiatrist and his team members, refused any meds, then declared I was checking out AMA (against medical advice). That’s when I was slapped with my first 5-day TDO. And that did nothing to improve my mood or willingness to take meds, which I really don’t want to take again. I’ve never felt helped by them and I’ve had awful adverse effects like horrid vasculitis rashes all over my body, weight gain, kidney problems, plus I just recovered from meds being discontinued without taper. I don’t want to experience withdrawal ever again. Nor do I want to see psychiatrists continuously for no real benefit.

 

The TDO was nearly over which meant I could try to leave AMA, but no. A nurse called me to my room, pushed me in there weirdly, and I looked up to see, in the doorway, 2 nurses, 2 guards, a sheriff’s deputy, and a police officer. Nobody would explain what was happening. Then the police officer entered and began writing up…oh, a TDO. Still, nobody talked. I asked why they needed this whole display and some assumption I’d go off, just to serve me with a TDO. No response, but the officer handed me a 30-day TDO and everyone left. What a performance. But I had to go to a hearing at the hospital the following morning so a judge could rule for it or against it.

 

Spoiler alert, the judge ruled for it. I had 6 people probing into how dangerous I was to myself, lacking in insight as to the severity of my bipolar and borderline personality diagnoses, and noncompliant around being treated with meds. The psychiatrist misrepresented several facts, which I tried to correct but I just came off as oppositional and “my lawyer” didn’t assist me in any way. The psychiatrist said that I had attempted suicide many times, but I never have. My self-injury has nothing to do with trying to end my life. He stated that 2 years ago I had a bad reaction to a med, so I stopped taking all of them, when it was a psychiatrist who had discontinued the meds suddenly. He also claimed I’d been in psych units at least 10 times in the past 18 months when I’d been free of psych hospitalizations from December 2019 up to July 2021. But it didn’t matter. The self-harm and refusal to be on meds was plenty for the judge and there I was, 30 days on a hold.

Later that day, I realized that agreeing to take some medication was my only way out. So, I offered that I would be willing to take lithium and a low dose of quetiapine. Well, that pleased the psychiatrist, and the meds were started that night. I wasn’t pleased but I acted as if it was a good idea after all.

Another part of successfully leaving a psych unit is attending all the groups held throughout the day. These include wellness skills, group therapy, creative therapy, and wrap up at the close of the day. Group therapy was facilitated by a seasoned female therapist who exuded warmth and had the skills to get patients to open up about real issues. She liked talking and asking questions and encouraging and was fine with outbursts of anger, knowing that’s how some people get to their feelings, and she helped me a lot. This is an example of one of her notes about me, reflecting joy that I was finding some ways to cope with the hospital:

 

She went on vacation the last few days that I was in, and a young go-getter type of therapist, a woman who I felt was cold and talked down to patients, who liked writing stuff on the whiteboard and then photographing it at the end of group then offering printed copies to anyone who wanted it for their toolbox, took the reins. The problem I have with all this evidence-based skill stuff is that the patient’s real feelings and struggles are ignored and replaced with do exactly this when you have this reaction. And, for me, that channeling into some programmed set of activities in a rote sort of manner is devoid of acknowledging my personality, intelligence, and spirit. These are her notes about me:

 

The occupational therapist had the same kind of approach and requested that I write out a schedule of what I would do each day, hour by hour, when I got home. I did it, but it’s not my style, and I don’t mean that scheduling is completely useless, but I’m not about to account for every bit of the day like I’m a robot. But this is what I filled out, to be compliant:

 

Now, to return to how things were going with the psychiatrist, well, not great. I became very concerned that he’d keep me the entire 30 days, or even TDO me again after 30 days. I kept asking when I’d be discharged and he couldn’t say, and I became angry, insisting this wasn’t treatment, but a sentence I was forced to serve. That’s when I decided to employ some methods of nonviolent action, per the book From Dictatorship to Democracy by Dr. Gene Sharp. My first action was to tear squares of paper, many of them, and on each I wrote the same sentence:

This psych unit is my prison.

All the offices where the psychiatry teams and social workers met daily, in the back hallway, had signs outside and you could slip papers in them. So, I did, on the sly, 5 notes at a time. And when I saw that those had been removed, I placed 5 more around, and continued doing this sporadically for 2 days.

The sign outside my room allowed for sliding in an entire page, and I used that to post this artwork:

 

Then I told the psychiatrist that my new cat’s care was too expensive, and she deserved someone at home with her all the time, so I was going to have her sitter take her back to the shelter. I had absolutely no intention of doing that, but wanted to press the psychiatrist to hurry it up and let me out. I stuck to this for 3 days, but it got me nowhere.

Then I had a relative of mine, who’s an MSW and psychotherapist, call the psychiatrist. They apparently had a good conversation, but I got nowhere again, sort of, other than the psychiatrist assuring me he didn’t plan to keep me the full 30 days. So, I calmed down and just did the behaviors that showed acceptance of mental illness and needing drugs and ongoing care once released. And the day finally came when I was told I could go home September 1^st. The psychiatrist explained that he had to do TDO’s to get me to take meds. He was trying to save my life. Is that noble? I find it coercive. These are some of his notes about me:

 

The day I left the hospital, the psychiatrist approached me. He had his phone out and asked me to look at the screensaver, telling me that it was his cat who’d died 2 years ago, but he just couldn’t take the screensaver off. Was that supposed to be a bonding moment demonstrating that he did know my pain? Well, he did a good job ignoring it the whole time he was in charge of me.