Tangled Up in Points of View

Mental illness, places it occupies, are messy and raw and if you tried to firsthand report, jumping in gonzo journalism style, you’d be confused about where to start and how to get an opening and where to end. You’d be shut down. Patients are protective, especially if they’ve been around, and back, and around again. Like me.

The only order in going into psychiatric hospitals is what they don’t let you have.

The only way to know what other patients think and how their lives are is to be locked in a ward with them.

But it’s still elusive. There’s a lot of chaos there and hidden emotions. I’d believe I knew the patterns in mental illness and had concrete answers when it was impossible to make such formulations.

Conclusions about mental illness can’t be drawn with certainty, even after sharing experiences from all walks of life with people in all kinds of mixed states and dissociated parts and degrees of willingness to participate in treatment.

painting I made about my history of mental health treatment called Hard Stories to Tell

My first time in a psych hospital, I was 17 and had overdosed. The psychiatrist kept me there for 2 months. No meds, just containment. This was in 1980, when there wasn’t a good handle on medicating adolescents, but anyway, I stayed at the hospital. Six weeks in, I was allowed off the floor for small bits of time. I’d bum a cigarette and go 3 floors up to a mostly empty wing and watch myself smoke in a bathroom mirror. The older women patients would try to outdo each other’s self-harm, with ingenuity, surreptitiously taking curtain hooks or forgetting to return razors to the desk. A guy danced on top of a table one night, gleefully yelling that at least when he got out, he’d have a paper saying he was sane. An old woman screamed about spiders under a chair.

A few hospitalizations on, I landed at St. Elisabeth’s, a sprawling gothic Victorian probably haunted psychiatric hospital in DC that’s now closed. I ended up there because while seeing my psychiatrist in DC, I talked about self-harm, and even though I lived in northern Virginia, the police were obligated to put me on a hold in the District. And not at any nice place because I’d aged off of my parents’ health insurance coverage and I had nothing. Three large nurses strip searched me as soon as I walked in the unit doors, not very welcoming. There were 6 of us stuck into one bedroom with 2 beds and mats on the floor. Nobody did therapy there. We all just sat in a big room. There weren’t amenities. This was a city hospital in a largely black part of the city. Patients didn’t want to talk to little white girl me from the suburbs. I didn’t learn anything about anybody there and it was best if I sat as still as possible, which I did for 2 weeks until I was discharged.

I wasn’t always in psych units. Sometimes I was out deciding not to take meds and drinking and smoking weed and running around with gay friends who kept asking if I was gay. They’d take me to nightclubs in the bad part of town because that’s where gay clubs were hidden. I felt the need to do some performative gayness by following a woman back to her apartment. She tried to woo me with music. She kept saying it was her music. But the music was actually muzak, that crap piped into elevators, so I left, which was a gamble because I didn’t know if my friends were still downstairs. But I found them, and we drove home. I really am gay and did find a girlfriend, briefly. The attraction centered around us being of the same age and having been in mental hospitals. It wasn’t a good basis for a relationship, so it didn’t last. I was nocturnal. I ran around in the middle of the night, all hyped up on bipolar mania, meeting dubious, maybe dangerous night people, sliding off into darkness to smoke joints, riding around drinking. Safety wasn’t my concern.

painting I made of cryptids seen in the night

Nothing was ever just a relaxing time with friends.

Sometimes I’d get together with a person I’d met during a hospitalization. That wasn’t ever heartwarming, more like peculiar and unhealthy. There’d be an obsessive discussion of treatment and then a game, like who had it worse, whose illness was worse. One woman would finish my sentences, but not aloud, more like I could see her lips forming words. She desperately wanted me to have my hair frosted, a thing we did back then. She pleaded, “I’ll pay! C’mon.” So, I did. And that felt weird because she started acting like she owned me. I backed away and made sure to lose her phone number.

I was hospitalized so many times. I’ve lost count but have a reasonable estimate of 60+ inpatient stays in 25 different hospitals in 3 states and the District of Columbia.

I don’t know if I was just so mentally ill or nobody treated the PMDD component or meds weren’t enough or were too much, or I was difficult or I needed to get clean and sober. I’m me, here inside this mind and body, and I don’t know. It’s always speculation if clinicians aren’t getting to know me, and it’s the most educated assessment they can offer if they do.

In college, working on an art degree, I thought the answer might be in becoming a famous artist. Simultaneously, I thought I was an imposter, but that salvation might come from following the Grateful Dead around all summer after graduation. What really happened is I tried to work and then I quit, even though I was good at it, because depression numbed me out. I set up a canvas intending to paint that depression right out, but there it was, on my canvas, muddying the colors, a glob of a figure barely defined under heaps of grey.

I pulled out of that, sort of, by smoking a lot of cannabis and then starting a decade long nonsexual relationship with a coercive, dominating, emotionally abusive man. And that worked for me because I just wanted someone to tell me what to do. I left him because I’d visited San Francisco and I was excited to embrace my gayness, to celebrate it, and to try life on my own.

That first year was good, but then the depression and the anorexia and the mania and the pull to self-harm battered me. My supportive girlfriend and all the cannabis in the world weren’t making me right again, and the hospitalizations started up.

Northern California was a whole other trip through the psych wards, like a tour without all the fun and cool souvenirs. The ER staff saw me coming and the only question was which hospital had an available bed. Would I be at John George where my self-harm was so feared that they’d put me in four-point restraints during the night, or would I be at the hospital in Berkeley where staff walked us over to Starbucks every morning for smokes with coffee? Or any of the myriad places between, because it could be anywhere. I didn’t have any visitors, so I’d run out of smokes and have to be under some other patient’s control, doing their bidding to be supplied with some. Smoking is very important to many mentally ill people. It’s calming, something to do with your hands while tossing thoughts around, something to have control over. Most hospitals don’t allow it on their grounds, but in the 90s, it was still acceptable.

At one hospital, a single psychiatrist ran the unit, everyone’s treatment plan, and he had ECT available that he wanted to use extensively. Not that he got his way, but he certainly pushed it. I was severely anorexic at that point and was told to either do ECT or be tube fed. I did ECT, but didn’t like it, so I ate some food for a day. Then they put me on a bus home, instructions for my next bus transfer pinned to my shirt. Somehow, I found my way. Over the years, I haven't dwelled on that. I’ve actually thought more about 2 other patients there. One young woman was nonverbal, and her mom sat with her all day and helped take care of her. The other was an older woman, my roommate, who was trying to stop misusing pain pills. Her daughter wanted to take her home and get her into the right program. She was anxious, asking me, “Should I go? Or do ECT here? Or just stay here?” She sounded so desperate. Finally, I told her in no uncertain terms that her daughter loved her, and she should get dressed right now and go home. She did. At times, fellow patients were the only ones helping other patients. Or staff assisted but only other patients heard the deep stuff, the inside and dark and maybe nasty or too wildly or creatively expressed stuff for staff to handle.

In 2021, I was detained twice at a northern Virginia hospital, after I’d decided meds were the problem and psychiatrists were evil while bipolar disorder said, okay but I still exist. I didn’t want treatment though. In fact, I saw the hospitalizations as an opportunity to educate all of the patients about how they were being duped and damaged and that their mental illnesses were only real to them because they were told they were, without realizing how twisted that sounds. Anyway, I was met with blank stares. And I feel bad because I put a woman who was in bad shape off of doing more ECT, and that was not my place, and I wasn’t an expert just from having courses of ECT twice in my life.

In my most recent hospitalizations for severe depression, I stopped trying to be an idea of mentally ill or not and was able to work well alongside the psychiatrists to determine a meds regimen that’s really helped. It’s not a guarantee. I thought that when I felt great on meds for all of 2023, it should last. If it didn’t then I’d blown it by not keeping the discipline of eating right, taking walks, going to art club, drawing, keeping up with family, and so on. But it’s not like that. Because all of this is messy and you’re bound to get dirt on your hands and to look around at what you thought was all figured out to see it in disarray.

I found out that I’m a good listener and other patients like to tell me about their issues, for the most part, and I have good intuition in observations I share. We’re all looking for a way forward. Or maybe not until we get relief from feelings and behaviors that are like torture despite all that we do to quell or distract or destroy.

I’ve been able to know other patients’ experiences in a nuanced way free of me judging them based on what they think of treatment and diagnoses. And I’ve found the generosity of people from different cultures and backgrounds telling me how they view mental illness and how it’s handled in their communities and bonding over parts we have in common.

In 2002, I did get clean and sober. Last year, I gave up smoking. Some don’t, and the effects on health are yet another problem, another source of exacerbation.

I sit back, this time not taking a drag off a cigarette. I laugh at the wild ride I’ve been on, the gritty honesty of it, the sense of adventure, getting out of trouble I found myself in, living another day. And then I tell myself not to romanticize. And then I say, that’s how it went down, in a spectacular show, a ball of misery, dances in the moonlight, pain that shot the sun from the sky.

I’ve only described a sliver, some snapshots, of what my life with mental illness has been. I guess the motto is “always expect the unexpected”. It’s also about survival and self-respect and respecting others and not intruding into places uninvited. It means never having the answer, only some answers sometimes. It’s about recognizing that everyone will have their own unique approach within options and within parameters and in their own minds.