Commitment

TRIGGER WARNING: depression, voluntary mental hospitalization, suicidal ideation

This essay describes my experience with being voluntarily committed to a psychiatric ward. Self-committing to a psych ward is a last-resort safety measure taken by people with severe mental illnesses that causes the person to be a danger to him or herself (or, more rarely, others, though those people are generally committed to a different sort of ward than the one I experienced).

Psychiatric wards of all stripes are shrouded in a great deal of mystery and fear. People imagine the experience will be like Chief Bromden's in One Flew Over The Cuckoo's Nest: a nightmare of medication, restraint, oppressive nurses and guards, and inescapable confinement. This is not the atmosphere of modern US psychiatric wards (though some are worse than others; mine was very good and I do not know if this is the norm, or an improvement over normal conditions).

My hope is that this essay will take away some of the mystery and fear of psychiatric wards for mentally ill people who may need hospitalization in order to recover. I want people to know that they can be nurturing and supportive environments that aid recovery; that they are not simply holding tanks people are locked up without any help or friendship.

For a variety of reasons, I was suicidal. My self-esteem was at all-time low, I was utterly convinced of my worthlessness, I did not believe I deserved to live. All that held me back from killing myself was a fear of pain and a residual terror of death--no, that is not quite true. Like many suicidal people, I did not want to die so much as I could not bear to continue to live. I desired change but did not believe change was possible.

This is in many ways the essence of what it means to be severely depressed: life is unbearable for whatever reason, and the sufferer does not believe there is any escape. In general, this is not true. Depression warps the experience of reality and the ability to rationally consider one's position. At its most extreme, depression robs life of meaning and purpose until the difference between life and death seems only slight.

This was the state of my mind when I called a suicide crisis line.[1] I was no stranger to crisis lines. I had been using them for six months, had reached the point where I was very familiar with some of the people at the crisis center I was generally routed to. Crisis lines can be a godsend. The people who staff them are trained to talk people through their problems quickly, know methods for distraction and grounding, and can help refer callers to other resources. Most importantly, they provide a sympathetic ear at any time of the day. Given that depressed people tend to isolate themselves, this may be the only sympathetic ear that they have.

This time, my self-hatred was so high and my will to live so low, that I was advised to go to the hospital emergency room. Emotionally, it was very difficult for me to get there. I did not want to admit that my problem was that severe, I did not want to have to surrender control of my life, I did not want to need this sort of help. Going to the hospital was, I believed, the ultimate statement of weakness and failure. I believed that going there meant I was too weak to be able to handle my problem, that it meant I would never be free of my depression.

I no longer believe this. I now understand that depression is an illness, one that can be terminal if it is not appropriately handled, and that needing help with it says nothing about the sufferer. I understand that an inability to handle depression on one's own is no different from an inability to heal from a broken leg without assistance. It is important for people to know this. So many people refuse help because they are afraid of looking weak, or deride others for seeking help because they do not understand this.

I listened to the woman on the crisis line and went to the hospital. I checked myself into the ER, and waited. Not long after, I was taken to the psychiatric emergency department. There, my vital signs were analyzed, and I was interviewed by a psychologist. I was incoherent. I couldn't even babble. The strain of my own depression combined with the humiliation of being in the ER rendered me incapable of doing anything but cry. Because of this, I was given an anti-anxiety pill to calm me down.

Haltingly, I explained why I wanted to die. I had told the story many times before and was used to telling it. It still came out slowly this time. It was far more real than ever before. And after I told it I was given two options: I could spend the rest of the day and night in the ER, or I could go to a short-term psychiatric ward where I would take part in group therapy, daily contact with a psychiatrist, and be checked on regularly to make sure that I was “safe.”[2] I chose the psych ward.

Not all psychiatric wards are the same. Some are designed for longer stays, some house people that are there against their will; I would later be placed in another short-term ward that had less intensive care (and was far less costly). The one I was placed in was entirely voluntary; I could leave at any time if I so desired, but was advised to wait until the psychiatrist in charge of the ward believed I could be discharged safely. I would absolutely advise anyone considering hospitalization to ask about the nature of the ward they're considering to make sure the conditions on that ward are acceptable to them.

It was late when I was taken up to the ward, so after briefly interviewing me, I was sent to bed. That morning I woke up early, something that would become a habit for me on the ward (though it didn't carry over when I returned home). I was already dressed in purple scrubs, which were mandatory until highest-surveillance suicide watch was taken off, but I showered and went to the main meeting area where breakfast was served.

Meals on the psych ward were optional, and could be taken communally or alone in the patient's room. I always ate with the group unless I had friends or family visiting during a meal. This was a good decision, as it gave me an opportunity to meet the other patients socially. This was important because, on the psych ward, the other patients were the main support network.

I cannot stress this enough: While the therapists, nurses, and psychiatrists were important, it was from the other patients that I most benefited. The assortment was huge. There was the older man who was a successful businessman who turned to drink every time a venture failed, the mother with rheumatoid arthritis who had been in the ward on several occasions, the young woman with bipolar, the teenager with drug addiction problems, and so many more. All of us were there because, one way or another, our lives had led us to hit rock bottom. We wanted to kill ourselves or couldn't provide even the most basic care for ourselves because we were too shaken by life. And that was common to everyone, so there was very little judging by the patients. We recognized that here we were all equals, all of us had suffered and there was little point in arguing over who had suffered the most.

The days had a regular pattern. Breakfast was followed by a goalsetting group. In this group we would name three emotions we were feeling, a personal strength, and a goal for the day. These goals would not be very big. People would resolve to eat their whole meal, to say something to a family member, to correct thoughts of self-hatred. Nothing very big; the psych ward wasn't a place for big thoughts or goals. It was a place of countless small victories, and they were all celebrated and remembered.

That would be followed by another group session, perhaps a discussion group, or a lecture by a chaplain, or a lesson on self-care. These groups were where we learned the most about our fellow patients as we unburdened ourselves of our stories and our emotions. The one that most springs to mind is a discussion lead by a Russian Orthodox chaplain on my first morning on the ward. He discussed what it was the made us feel bad, and explained to us that if we felt good when we did a good thing, that was a pretty big sign that we were probably good people. More importantly, if we felt bad when we did a bad thing, that was also a sign that we were good people. Thinking in this way liberated me from a lot of my feelings of self-hatred and worthlessness. I could see how it was possible to feel as horrible as I did without being a horrible person.

This would be followed by lunch, during which time family members or friends could visit. Although it had taken a lot of courage, I had told my immediate family and closest friends that I was on the ward. And they visited me. They brought books and hugs and occasionally treats that were unavailable on the ward. I learned that, if I needed them, my friends and family would be there for me, that they cared about me, that I was someone who deserved their care and affection.

Lunch would be followed by another group session, then a period of rest during which we could nap, read, or work on our goals. Depression generally makes me very lethargic, so I would often need to nap. That would be followed by yet another group therapy session, then dinner. Dinner was followed by a closing goals group that mirrored the morning one. The only difference was that we talked about whether we'd met our goals rather than setting them.

Sometimes after that we would be taken for a walk around the hospital, which was always a treat. The ward was small and the only opportunity for exercise was a single stationary bike. These walks were a chance to see the rest of the hospital and to socialize with our fellow patients and whichever therapist was taking us on the walk.

The final aspect of life on the ward was the daily meetings with the psychiatrist. He (I mainly interacted with a male psychiatrist) and I talked about my life, my problems, and my medications. These meetings could be difficult for me as we touched on subjects that sometimes made me uncomfortable or brought my self-hatred to the surface. I would slap myself during sessions with him, especially at first, and almost ran out crying after a family meeting with me, him, and my father.

He diagnosed me with Asperger's syndrome and an anxiety disorder on top of my depression. Paradoxical as it sounds, anxiety disorders are often comorbid with depression. This is because depression does not always simply depress emotions. It can also aggravate or magnify them. Depression is best thought of as a family of emotions, rather than as a single emotional state. Although it tends towards a low-energy state, but it can also provoke very high-energy states such as anxiety and anger. It was anxiety that spun the wheels of my most suicidal moments, working me up into a more and more nervous state until I believed I had no alternative other than death. It was anxiety that pushed me thoughts into the darker corners of mind and kept me thinking long after there was any usefulness to my thoughts.

I was discharged after three weeks on the ward (the average stay is two weeks on that particular ward). Was I cured? No, absolutely not. But I was stable, I could function in society safely. I didn't have a great sense of self-worth, but for the first time in ages, I did not believe that my lack of self-worth was an accurate perception; for the first time in months, I believed I could someday be happy; and for the first time in years, I knew that I was not alone in my struggles. The psych ward restored my basic dignity to me, gave me back the humanity I had thought I'd lost. It introduced me to people that were in the same place that I was, and taught me that being at the bottom of the ditch didn't make me bad or inferior, it taught me that being weak didn't mean being broken. It taught me to be far less judgmental of others, that almost everyone is in a place of some degree of pain. It taught me that I could live.

--Leum

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[1] The one I generally used was 1-800-273-8255, a US hotline. ↩

[2] “Safety” is a jargon term in the mental health world. It refers to the patient's desire and ability to kill or hurt hirself. ↩

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Comments

[xxxp]

thanks for this = i needed to hear it today

[Nora]

This was a courageous post. As a parent of someone who was in a very similar situation last year, I feel for you and am glad that the hospitalization helped you, as the intensive outpatient program helped my child.

[Nev]

Thank you for this. I remember how humiliating it is to go to the ER, and reading about how the psych ward helped you is very peaceful.

I haven't been in a psych ward myself but might comment briefly about my stay in the Gerstein Centre later (if I have time and people are interested).

[Anon for this]

Thanks for this. Breaking down and being institutionalized has been one of my biggest fears. It's good to hear a real,non-terrifying experience.

[cyllan]

He discussed what it was the made us feel bad, and explained to us that if we felt good when we did a good thing, that was a pretty big sign that we were probably good people. More importantly, if we felt bad when we did a bad thing, that was also a sign that we were good people. Thinking in this way liberated me from a lot of my feelings of self-hatred and worthlessness. I could see how it was possible to feel as horrible as I did without being a horrible person.

Oh.

That's sorta revelatory right now. Thank you; I needed to hear that, and I greatly appreciate your courage in posting this essay.

[DS]

This question may sound insensitive, but it's one that I feel needs to be answered:

Did your insurance company find out about this, and if so, did they say anything? Did your premiums go up?

I have grappled with various emotional problems for much of my life, but for the most part, I have kept away from institutional help, because I've been terrified about compromise of confidentiality. Perhaps this itself is a symptom of a larger problem, but I can't help but feel that any sort of treatment - anti-depressants, visits to a therapist or psychiatrist, or institutionalization - can never truly be hushed up, and somebody you'd rather not know about it - a landlord, an insurance company, a potential employer, a potential romance - will eventually find out, and there will be consequences for it. Even if the other party breached the secrecy, once they did, you'd have no remedy - you could collect damages, but the secret's out forever.

Of course, this is what I'm frightened of.

[MaryKaye]

I can speak to DS's question a little.

I have been treated--medications and therapy--for depression. My spouse has had medication, therapy, and hospitalization.

We have not had any trouble with our insurance company, though we are lucky enough to have an exemplary one. We charged my treatment to my insurance, so there is no question that they knew. (My husband's severe depression was while we were unmarried and uninsured, but when we married and I put him on my policy, they were made aware of his history.) My concern is that insurance companies come in all kinds, and some are more evil than others--we were lucky.

I have not had any trouble with my academic employer, even though there are certainly people who are aware of my medical history at my university, including my immediate supervisor.

When I needed family medical leave to deal with my adopted son's mental illness, I did encounter some concerns from the HR department at the University. They seemed to me to have an exaggerated fear of revealing the mental illness to anyone, even when that was necessary in order to get me the leave I needed. They eventually did do the right thing, but it was stressful.

When my husband and I applied to adopt a child, our history of depression was a serious issue for DSHS. They asked me to sign a disclosure agreement so that they could talk to my therapist, and they asked my husband to undertake (and pay for) a psychiatric evaluation. They asked a lot of borderline hostile questions about our ability to care for a child. This certainly added stress to an already stressful process. We, and our medical professionals, steadfastly told them that our depression was well controlled and would not be a barrier to adoption, and we are now adoptive parents. (The private adoption agency which actually facilitated the adoption was much less problematic than DSHS. But DSHS was problematic about everything--mental health, religion, lifestyle.)

My personal attitude on this is that, while privacy is nice, the need for privacy on this topic reflects a harmful social stigma. On the other hand, mentally ill people need their resources to heal--it is not always going to be reasonable for them to put resources into fighting stigma as well. But as a recovered (mostly) mentally ill person I *do* have the resources, and I choose not to keep my treatment secret. So far, though it made adoption harder, it has not otherwise cost me.

My adopted child is also prone to depression. I think that our experience of depression helps us understand and tolerate this better than another family might, though sometimes we do end up with a household full of clouds of gloom. That's where a strong support network helps.

As for romantic partners, sod them. If a person can't handle that you were depressed in the past, you do not want to be living with them the next time--and depression tends to reoccur. I'd say the same about employers, if it weren't for the jobs crisis--right now saying "I won't work for someone who would discriminate if they knew" is more leeway than many of us have.

This may also vary by where you live, what you do for a living, and what social stratum you're in. The intensity of the stigma varies a lot. Academia in Seattle is a good place to be "out" on a variety of topics (religion, sexuality, mental health--not necessarily politics though). There are certainly much worse ones.

[Mmy]

@MaryKaye: while privacy is nice, the need for privacy on this topic reflects a harmful social stigma. On the other hand, mentally ill people need their resources to heal--it is not always going to be reasonable for them to put resources into fighting stigma as well.

Totally agree -- which is why it is so important that those around the mentally ill fight against them being stigmatized. And yes DS it does happen although not perhaps in the places/ways one expects. I learned in my experience as a prof that you get a lot more general support and help if you are a football player and you break your leg than if you are a top science student and you are fighting a clinical depression.

On the other hand there are a lot of things people can do. I once walked a student from my office over to psych services and stood and knocked on the door of the theapist's office and personally handed the student over to someone who could help. And I know of other people who have done something similar. No one slapped me on the wrist for that action. No one slaps profs[1] on the wrist for not helping. We can make a difference if we are willing to take the time/effort.

[1] I mention profs here because much of my experience is in academia and because many students first realize that they have a mental illness while they are at school -- stress often exacerbating the symptoms.

[Literata]

Thank you, Leum.

I would just like to point out that based on the testimony of family members, quasi-involuntary commitment is not at all the same - it can, in fact, result in a "One Flew Over the Cuckoo's Nest" situation, which is one more reason we should support sufficient funding of public institutions, including those we hope we never have to use.

[Leum]

In our situation, we weren't allowed to get too close to any of the other patients -- staff would redirect us if we talked too much or seemed to be forming friendships, and we weren't allowed to touch anyone or be touched.

Forming friendships was encouraged on the ward, but we were discouraged from maintaining those friendships once we got out. This was for fear that a) associating with people we'd met during a high-stress point in our lives might trigger us; I've maintained one friendship from the ward, and she doesn't trigger me ever, so I'm not sure how accurate that is and b) they don't want to house people who know each other on the same ward for confidentiality reasons.

We also were discouraged from touching each other, as that could violate boundaries for people who were sensitive to touch but didn't have the skills needed to tell people not to touch them.

[Laiima]

@Leum, I've cycled in and out of clinical depression since at least age 11, and I don't think it ever occurred to me to call a suicide hot line. I probably should have, because I have certainly been suicidal before. I'll keep that in mind for next time, if there is a next time.

When I was going through the stuff with my cousin, I thought longingly of being *cared for* by people who only wanted to help ... but I knew my parents would never pay for that. Partly because of the stigma, but mostly because they just wanted me and my problems to disappear, without having to deal with them and certainly without having to pay for them. So even if someone had suggested it, I would've been too afraid to try it, in case my parents made sure I couldn't get back out.

As an adult, I've never been directly treated for depression, but I have been treated for PTSD. I've been very careful about paying for that myself, rather than going through insurance. I did finally recover from trauma onset PTSD, but it took 20 years, including about 10 years of counseling. (I still have the chronic PTSD.) It was very important to me to recover, so I made it work, but it was a financial hardship.

Thank you to everyone who talked about their experiences.

[cjmr]

Not ready to talk about it yet, but this post directly touches on some of the problems we (the cjmr family) are having.

Thank you, Leum.

[cjmr]

I see Typepad lost my sign in again. That really was me.

[Patty (iambipolar2) Hauer]

I have been in many different styles of psych units. I live in a rural area and have been in small city hospitals to big city hospitals. Some offered more than others. All were scarry to go to the first time but the second time I found great relief within two hours of arrival knowing I was safe from myself. Now my task at hand was to regroup enough so I could go back home and finish my return to stability. That invoved may groups ranging from educational, recreational, and crafting skills for motor function improvement. All of the time I came home with new friends who I would never see again but remember fondly. Thank you for demystifing psych ward stays.

[Anon for this]

Thank you for this. A couple weeks ago, I went through with the difficult decision of taking a medical leave for mental health. Voluntary hospitalization has often come to my mind, so this post had perfect timing for me. At the same time, it demystified voluntary commitment (so I have more knowledge and less fear to make that decision if I have to), and it helped me step back and assess my own mental well-being, so I could see that (at present) I'm probably well enough not to take that step.

Although, given the audience of this blog, you're probably preaching to the choir, I'm also glad for your message of destigmatizing mental illness. Our brains can get sick and broken sometimes, just like any other part of the body, and there's nothing shameful or blameworthy about it.

[J. Random Scribbler]

Thank you for this, Leum.

TW: suicidal ideation (erring on the safe side, maybe?)

I went through something similar in my last year of college; the short-stay psych ward at the county hospital. In prior years at the college I'd heard about this person or that person "going to the fifth floor", and there was always sort of this awkward pause where nobody knew what to say. There wasn't exactly a stigma about it, but there was definitely a "wow, they must be really screwed up" feel to it every time

Oddly, even though I had recurring depression all through college and it kept getting worse and worse, I somehow never made the connection that the psych ward was an option for me. Not because I was scared of being thought to be really screwed up; it just... never occurred to me. I guess it didn't fit with the story I'd had in my head for years, which I always figured would end someday with a really sharp knife or a walk down to the train tracks.

When I was down the lowest I'd ever been and wondering whether it was going to be days or weeks until I did it, somehow the school counselor got it through my skull that I really could just check myself in to the fifth floor. It was like a light turned on in my head. I didn't really want to die, after all; I just thought that was the only thing left that could make the pain go away.

The ward was... well, OK. At least it was safe, and a refuge from normal life. The staff were a lot more focused on medication than talk therapy, though there was plenty of that too, both individually and in groups. I can definitely relate to learning more from fellow patients than the doctors.

I remember being surprised by how many people came to visit. I was still too depressed to feel happy about it or to understand that this meant they really cared. I was there two weeks, which was all my insurance would cover, and I probably wasn't quite safe to leave-- but going there saved my life.

It's been a long journey since, but not as hard as it was before; I knew that there was at least some sort of safety net out there in case I needed it again.

This went on a lot longer than I meant it to. But please, if anyone out there is thinking about ending it all, at least consider your local hospital instead.

[Amaryllis]

Typepad, you ate my post again. What do you have against me?

Leum, so I'll just say thanks again for writing this.

Paradoxical as it sounds, anxiety disorders are often comorbid with depression. This is because depression does not always simply depress emotions. It can also aggravate or magnify them. Depression is best thought of as a family of emotions, rather than as a single emotional state.
QFT. I'm gald you were able to get an accurate diagnosis. Sending good thoughts for your continued recovery, and to everyone else who's dealing with similar problems.

[kisekileia]

Nev, I'd definitely be interested in your stay at the Gerstein Centre. I've looked at them as a place to volunteer, but always concluded that it probably wouldn't be a good fit because of their use of the term "psychiatric consumer/survivor"--I feel that that affords an inappropriate legitimacy to the psychiatric survivor movement.

[kisekileia]

It legitimizes the idea that mental illness is an idea created by the psychiatric community to keep people in line, rather than being genuinely pathological. It panders to people who refuse treatment because they are too sick to understand that they need it, even when refusing treatment harms them and the people around them. I have a longtime friend who almost died of an eating disorder because she grew up with a paranoid schizophrenic mother who refused treatment, so I have no patience with the idea that refusing treatment is okay when your illness is causing harm.

[Mary Kaye]

A friend of mine, whom I would have said had a decent support network, developed schizophrenia and ended up homeless and in and out of jail. At one of her jail hearings I met her parent, who turned out to be a Scientologist of the "all psychiatric care is malevolent and useless" persuasion. I think my friend had internalized that attitude in her childhood, and it resurfaced when she was ill even though she had rejected most of her parent's values. I can't help thinking that, while getting treatment for schizophrenia is always difficult, her chances would have been better without that ingrained fear and hatred of psychiatrists.

I agree that there are a lot of bad and useless ones out there; but "psychiatry is evil" strikes me as an attitude likely to increase, rather than decrease, the proportion of bad ones. Who would go into a profession that's widely believed not to help people, other than a sadist or a gold-digger?

[histrogeek]

I self-committed in my early 20s as a result of serious depression and suicidal thoughts (which had been going on for almost three years at that point). My own experience with crisis lines was awful. Yes I really did get put on hold; although despite my misery I found that amusing, a little gallows humor for a very bad time. I think the hospital line finally convinced me to come into the ER by simply pointing out that the alternative was staying alone at home and hoping the inner demons didn't overwhelm me.
I can't say that the actual committal was especially help except as a wake-up call that the depression, self-loathing, and suicidal thoughts were not as controllable as I had thought. For whatever reason I was only in the ward for two or three days. Mostly it was dull since apart from therapy sessions and meals there just wasn't much to do. One of the patients was simply not lucid enough to talk with. Several others, including a friend of mine from the outside, were too resentful, and in some cases delusionally hostile, to be conversationalists. It became clear that mentally ill are not always, or even often, the quirky interesting bunch you see in movies. The staff however was good with me.
My friend on the other hand stayed for several weeks, and frankly was worse in most ways after getting out. Part of this was that he had been made to face issues by quack self-esteem types at a retreat, which led to his committal in the first place. I don't know if he ever realized how much their amateurish actions screwed him up.
Maybe committal just works when the patient has some sense of what they need it for. Or maybe it's really only good for crisis management. I don't know, in 18 years I've never needed to go back thankfully. Outpatient therapy and medication were ultimately more effective than the hospital.

[histrogeek]

DS a few posts up mentioned fear of later costs. I haven't seen any despite multiple jobs shifts since then. I was able two years later to get into a very competitive program to be a teacher, which frankly would be one place where you'd think they'd be concerned. I fully disclosed that I'd been institutionalized so really they had the knowledge if they wanted to make a point. Insurance and credit haven't been a problem either.

[Will Wildman]

There's some kind of awareness-raising day going on in the building next to mine (the slogan "People helping people" was featured heavily), and I noticed it featured a booth for a 'psychiatric survivors' group. I didn't talk to the personnel, but their immediate messages seemed to be very much in the realm of 'people already having to cope with mental illnesses are sometimes mistreated by health professionals' rather than 'mental illnesses are a malicious fiction by health professionals'. Possibly there's more than one agenda claiming the label?

[Froborr]

TW: Self-harm, suicide, suicidal ideation.

I've been on the fence for a couple of weeks about talking about some of the issues currently going on in Casa Froborr, but this post convinced me to.

I self-harmed quite a bit in my late teens. I developed methods, which I will not share, for causing myself physical pain without doing any actual damage, and used them as a sort of safety release valve for self-loathing. Unfortunately, that was only a stopgap, and in the year after high school isolation, physical illness, and the ongoing depression finally got the better of me.

I tried to kill myself, but the knife wasn't sharp enough and I ended up not breaking the skin. I told my mother (I was still living at home at the time), my mother freaked out, and I ended up self-admitting to a local mental hospital.

As I was still 18, they gave me a choice of going to the ward for non-violent teens or the one for non-violent adults. I chose adults, as anyone with my experience of teenagers would.

It was very much like what Leum described. It didn't cure me, but it got me stable enough to return to life, and slowly (painfully slowly, at times) I healed. I can't say for certain when my last suicidal thought or the last time I self-harmed was, but by the time I finished college it had been a couple of years since I last hurt myself.

I finished college six years ago. Last weekend things at home got bad enough that I seriously considered just retreating into the bathroom and hurting myself. I didn't, but... that was the first time I even thought about doing it in seven or eight years.

I feel stuck. The person I usually go to for support is the person who's making me feel this way. It's not intentional, they're just badly depressed themselves right now, and supporting them is starting to trigger me. There's not really anyone else I can turn to--I don't really have any RL friends anymore, and my family are a pack of wolves, so here I am posting about it on Slacktivist. I feel guilty about commenting, because so many people here have overcome so much more, and partially written, then erased comments like this on several threads in the last couple of weeks. But I figure if any thread is appropriate, it's this one.

[Mmy]

@Will Wildman: I think a lot of the push/pull of the survivor's movement can be traced directed to the work/influence of Thomas Szasz who without any doubt brought attention to the shortcomings and dangers of psychiatry in the 1950/early 1960s but who went on to overreach and basically call lint question the reality of mental illness at all. The New Atlantis did a write-up of his work/legacy in 2006 The myth of Thomas Szasz (The title is a play on Szasz's most famous work The myth of mental illness

[Mmy]

@Froborr: Pthalo put it well -- "it's safe here at slacktivist." There is no bar that you have to reach before your pain is worth commenting on.

You are in pain. No one should feel as you do.

[MaryKaye]

Froborr, if you can't easily get additional support for yourself, can you get additional support for your depressed friend? Do they have friends or family who could take up more of the burden? Would some form of treatment for them be a possibility?

When my husband-to-be and I were in college and living together, he was severely depressed and borderline suicidal, and this led to increasing strain on me. I loved him but I was having a lot of trouble coping. I felt like I was manning a suicide hotline 24/7 and I couldn't do it. Treatment for him had the side effect of reducing the stress on me enough that I could continue to function, which was certainly better for him than me collapsing would have been. At the time I felt a lot of guilt that he'd had himself committed (for a few days only) mainly because of me, but in retrospect it was helpful to both of us, and no shame in that.

Also:

If you're hurting, you're hurting. Can't decide for your sprained ankle to stop hurting just because someone else has broken leg, you know?

This. A million times this. "Someone else is suffering more, so I don't deserve help" is one of the most toxic things depression tries to tell us.

[Froborr]

"Who is Szasz?"

Good Question.

*cues groans from three comic book fans*

----

@Pthalo and Mmy: Thanks. I grew up as the one whose problems flew under the radar (my mother was both physically and mentally ill, my father couldn't keep a job, my sisters were violent; I just had bad hygiene and didn't do my homework), so sometimes I feel like I need permission to be sick.

This *is* a safe place, isn't it? It still seems unfathomable to me that such a thing can exist.

@MaryKaye: Zie's already in therapy, but yeah. Getting more of hir friends involved would probably help. The latest crisis seems to have passed, zie has not been suicidal for a couple of days, and the main thing that seemed to break it was zie talking to hir boss, and said boss being really understanding.

[hapax]

"Who is Szasz?"

Good Question.

Sage answer.

{{{Froborr}}}

I wish I could offer something more practical than "I am listening. I care."

Don't ever be afraid to share or vent here. This is a community that continues to amaze and humble me with its collective compassion and courage.

------

Depression (or other mental illnesses) can be induced by neurochemical imbalances, by stressful situations, by dysfunctional patterns of thinking, by past or present physical/mental/emotional abuse (which can be a combination of all the above), by diet or allergies, by... so many factors.

It would be astonishing if any single form of treatment were effective for everyone across the spectrum.

In some ways, it would be helpful if we stopped thinking of "depression" as an illness, and more as a symptom, like "nausea" or "coughing."

Nothing to be ashamed of; nothing *necessarily* to be frightened of, judging the severity of which by how much it interferes with normal life activities.

Got painful stomach gripes? Maybe you should take a day off work. Throw up at the same time every day, or when you eat certain foods? Let's look at your diet, your activities, possibility of underlying conditions. Constant vomiting so that you cannot keep down a meal and you've lost ten pounds in two weeks? Umm, let's check you into the hospital -- and so forth.

[Froborr]

Sage answer.

Oh, well played. Well played indeed. (Thanks to the DCAU being my introduction to the DC characters, and 52 being the first DC comic I actually read, the Question is forever cemented as my favorite DC character, ugly Randian origins notwithstanding.)

{{{Froborr}}}

I wish I could offer something more practical than "I am listening. I care."

Nothing could be more practical right now.

Don't ever be afraid to share or vent here. This is a community that continues to amaze and humble me with its collective compassion and courage.

Likewise. The Slacktiverse is a special place.

[Nev]

Re: the Gerstein Centre -- it's a large house in a very quiet area near the gay village. People usually stay there for 3-5 days; there are two beds to a room but if it's not crowded they'll give you a room to yourself. You take care of your own breakfast and lunch (there's a big kitchen with everything you could want) and dinner is communal, at a set time. You can talk to the staff at any time if you need to talk to someone, and they can help with social services and getting meds to you.

You can come and go as you please, and when you leave is up to you. (It was a big relief being able to go home to feed my cat and pick up toiletries and things.) How you spend your time is up to you as well. There's art supplies, a deck on the roof, TV, a shared computer, some books (that's where I read The Android's Dream and Cryptonomicon).

I appreciated it very much for what it is -- a very easygoing transitional place between the psych ward or the emergency room, and everyday life. It made getting back to things a lot easier than other times when I've just gone from the ER to back home.

There's a wide range of stances among self-identified consumer/survivors and I don't know where the staff of the Gerstein centre fall. I got the impression that letting people be independent was important.

[cjmr]

This. A million times this. "Someone else is suffering more, so I don't deserve help" is one of the most toxic things depression tries to tell us.

And another thing I needed to hear this week/month...Thanks, MaryKaye!

[MercuryBlue]

*offers Froborr hugs*

[Laiima]

Tangential to the OP, but on topic about this community... I was thinking earlier today about what I was doing a year ago. I was getting ready to "curate" the hyperbolic crocheted coral reef exhibit at the Smithsonian, which was already a mixed bag because I hadn't personally knit or crocheted any items for it, nor did I know anyone else who was participating. (Every time I went to meetings, everyone else there was surrounded by friends, but I was utterly alone.) I hoped to meet interesting people by doing the curating.

So the day arrived, and I went down to DC. Instead of what I hoped to be doing - actually setting up the exhibit - I got to color sort items for two hours, along with two other volunteers, who I rapidly realized I heartily disliked. At the end of my shift I thought, "well I can send them invitations to connect to me on LinkedIn, and if they accept, I'll feel more connected to Greater DC." (This despite the fact that my policy with LI is to only invite people I actually *like*. I had never before (or since) invited people I disliked.) After all that, neither of them ever responded.

Contrast that with the Stewart/Colbert Rally in DC 6 weeks later where I met Fred and a bunch of other Slacktivites, some of whom were as excited to meet me (!) as I was to meet them. I realized I was truly part of this amazing group of people.

I was telling Mr Laiima just tonight at dinner that almost all of my social network these days consists of fellow Slacktivites. And that has made a huge difference in my quality of life.

[Laiima]

@Froborr, hugs if you want them.

[Brin]

Laiima: Contrast that with the Stewart/Colbert Rally in DC 6 weeks later where I met Fred and a bunch of other Slacktivites, some of whom were as excited to meet me (!) as I was to meet them. I realized I was truly part of this amazing group of people.

I was telling Mr Laiima just tonight at dinner that almost all of my social network these days consists of fellow Slacktivites. And that has made a huge difference in my quality of life.

Several people share the title of "person who linked me to slacktivist*", and I am grateful to them all (despite not being sure who they are). This is the community that made me decide to leave the lurker shell I was in nearly everywhere. Decide to choose a name rather than always using names others had chosen for me. Decide to speak and not just listen (though listening is good too). Once I'd taken the step here, it was easier to do so elsewhere, too. Almost all of my Internet presence exists because of here, and I love it.

*The first couple times, I read the main Left Behind posts, no comments, no other posts. Around the fourth or fifth time I checked for updates, I decided to look around the rest of the site. The rest is history.

As for the original topic, thanks to Leum for giving a positive account of a psychiatric ward. I'm glad to hear they're not all as bad as the stories I've read on the aforementioned Ballastexistenz.

[Froborr]

Contrast that with the Stewart/Colbert Rally in DC 6 weeks later where I met Fred and a bunch of other Slacktivites, some of whom were as excited to meet me (!) as I was to meet them. I realized I was truly part of this amazing group of people.

Dammit, I searched the whole damn rally for you people, never found you! I was so proud of my YGOTAS-themed sign, too...

Hugs are welcome, Laiima, thank you.

[Froborr]

I'm sorry, missed your post MercuryBlue. Hugs are welcome from you, too!

I'm feeling a lot better tonight. I went to Games Club after work, came in firmly in the middle of a game I'd never played before, it was fun.

[hidden_urchin]

TW: depression, family conflict

This is a well timed post and discussion. Wednesday morning I had a fairly unique experience (for me, at least). I was chatting with a classmate before class and she asked me a very innocent question. Instantly, I started feeling exteremly sad because it brought up a ton of negative memories and very emotional issues that I am, apparently, still working to resolve. I've spent the last two days crying on and off.

You see, six months ago I suffered a disappointment that I hope to God remains the greatest disappointment I ever face. After spending years dreaming about and working towards a certain goal, I learned that I would never have the chance to achieve this goal because of a genetic quirk. There is no appeal. There is no alternative. That future is closed to me.

When I first got the news I immediately feared that such a devastating turn of events would bring my depression/anxiety back after over a year of being free of it. I decided that if I gave myself permission to mourn the death of a dream then maybe I would have a chance to recover. So I went into my room, where I could express my emotions in private (I'm proud and hate it when people see me cry.) and cried. My heart was shattered and that was the only thing I could think of to do.

While I cried, I prayed. All I wanted was for one person to tell me that it was OK to mourn the loss of something that I had invested so much of myself in. I didn't want to be told to look on the bright side. I didn't want a problem-solver. I just wanted to know that someone else understood and I wasn't alone.

Then my mother came in and said, "I don't know what's going on with you but you need to stop throwing this pity party and get out of your room." She did come back and apologize but I don't think I'll ever forget that. I didn't think I could feel any worse after my disappointment. I was wrong. That was the worst part.

Not only do I think that healing from this disappointment is going to take a lot longer than I initially thought, I'm not getting much help from my family here. To them, what happened is no big deal. And so, they bring it up frequently. When I begged my mother, crying and walking from room to room to avoid the conversation, to please stop talking about it because it was hurting me she said, "I can't believe it. You're the most manipulative person I know."

Yeah. See, she sees pain as relative. To use the Pthalo's image, she figures if someone else has a broken leg, or if one of the options is you could have a broken leg, then you should shut up about the sprained ankle. I even used to view things like that. But I've been there now and I can only say that I was very wrong.

So all I can say, to whoever needs to hear (read?) is, "You are not alone. Your experiences and emotions are just as valid as anyone else's. You deserve to get what you need to heal in your own way and I hope you get it." {{hugs}}

Tangent: Wednesday was my first encounter with a triggering statement. Although I had understood the idea in the abstract I had no idea what encountering one was like. It blindsided me. Yikes. To anyone I may have inadvertently done that to in the past, I apologize.

Alright, now that I've written a Wall 'O Text maybe I can get to sleep instead of crying my way through a box of tissues. Thanks, y'all, for being out there.

[Froborr]

http://tvtropes.org/pmwiki/pmwiki.php/Main/YouAreNotAlone

Scroll down to the "Real Life" section.

[Another Chris]

Thank you very much for this post, Leum. I've never been to a psychiatric ward, but I have had emergency counselling and been prescribed antidepressants (which worked out very well), and I really want these problems to become less stigmatised. Why should emotional or mental problems be something to be ashamed of when (most) physical ones aren't?

As someone who's experienced both, I'd argue that depression *feels* different from being sad because your life actually sucks. That's not to say the second isn't horrible, but I don't think I could mix up the two. Depression has a sick feeling to it that you don't get in cases where your emotions are caused by outside awfulness. But I'm sure there are cases that are blurrier than what I've been through, or where (God forbid) the two interconnect.

For all the people in the thread who have current problems: I wish I could do more than say that I think about you, but it's all I can do.

[Izzy]

Hugs to all who want them.

I've never been hospitalized overnight for my issues, but I did end up going to the ER twice for panic attacks. Not a pleasant experience, but a useful one.

And I tend to agree with Hapax on the symptom/disease thing.

[Laiima]

@hidden_urchin: hugs if you want them. The family dynamics you related sound awfully familiar (which unfortunately is never a good thing).

Beyond that, I don't know what your specific disappointment was, but I had a similar one a year ago. I had spent about five years going through a process of trying figure out "the ideal job/career" for me, finally settled on information design, and just a few months later found out that I not only have carpal tunnel, but also some other un- or partially-diagnosed condition in my joints which makes it impossible for me to spend the time at a computer 40+ hours a week anymore.

So not only is my 'ideal job' impossible, but I'm not sure what else I could do as a paying job, as all the ones I've had in the last 20 years involve sitting at a computer, typing, for 40 hrs/wk. I haven't had a paying job in over two years, and I don't know what to look for. what if I never work again? How will I fill up my days? if I'm not earning money, is my life worth anything?

If I were still talking to my family of origin, their answer to my question [what is my life worth if I'm not earning money] would be: Nothing. Which is where my 'work ethic' comes from actually. Those other times I've been unemployed, to them I did not exist.

A long-winded way of saying, I empathize. It sucks to be in this frame of mind.

But you have a right to your emotions, and your mother sounds like a narcissist, who needs to make everything all about hirself. Don't listen to what she says.

[Lonespark]

Leum, good post. Brave, too.

Reading this yesterday was very hard, and the comments more so, even though I had a good day yesterday. The anxiety/depression combo punch is just very tough. And I had absolutely no inkling, growing up, that I could be prone to depression; I looked on, sympathetic but baffled*, as friends went through it. Yet the anxiety and obsessive thought patterns were always there, and really helped snowball the depression that I did eventually get.

*Because we need a lot more education about mental illness, and not just in health class, although would have been a start. I feel like they were kind of trying to get at this by having us do exercises to supposedly build or maintain self-esteem, but it was really misaimed. (And tied up with admonishments to Just Say No. Well guess what, Nancy Reagan et al? I know alot more kids who struggled with substance abuse through self-medication than because they thought pot was cool. And in many cases they/we were emulating family members or other respected role models. People who were examples of how not to be "weak." Undiagnosed/untreated mental illness is implicated in So. Many. Problems.)

[Laiima]

Since I haven't said so explicitly in this thread, but Lonespark reminded me, I not only deal with cycling in and out of depression, but anxiety disorders beyond my PTSD.

I've read things that suggest that families with a high incidence of ADD have unusual brain chemistry that may predispose them to other disorders. Pretty much everybody on my mother's side of the family has ADD, and most of them have indeed struggled with substance abuse which I think was, exactly as Lonespark said, because they were self-medicating. None of us were socialized in a healthy way; we all have trouble making friends, and even more with *keeping* friends. Which means social networks tend to be heavily-family, so everyone around you is self-medicating, which makes it seem normal or healthy. I've detached from them, as best as I can, but I still have wonky brain chemistry, social anxiety, depression, etc., etc.

Iow, sometimes I wonder if having a shitty (i.e., toxic) social network could conceivably be better than being as socially isolated as I am. I know it isn't, that they are all miserable too, but it's all so hard sometimes.

[renniejoy]

Hugs to anyone who wants them.

[Julezyme]

Leum, thank you for sharing. It's good to know that there are places like this, and that it's okay to need, seek, and get this kind of help.

Froborr ... I'm sorry you're going through this. I know the allure of self-injurious behaviors and how scary it is when those urges resurface. If you ever want to talk (write) ... Well, this is the real life.

Off topic (?) slightly but related to this thread - sometimes, especially when I am feeling crabby or headachy or raw, and I find myself getting irked by a stranger on the street, or thinking uncharitable thoughts about someone on the bus, I think - "That could be a Slacktivite. That could be Kit, or Laiima or Will Wildman visiting." And then my thinking changes; whatever was irksome stops being so irksome, because I feel a sort of loving connection.

I have a lot more I want to say in this vein, but I can't get it to come out right right now. I just wanted to say, this community is special.

[D]

I want to say thank you for a excellent description of what life is like in a real world psychiatric ward versus the version shown on television. I recently spent a week in one following an involuntary commitment under Section 10 of the Canadian Mental Health Act and am currently adjusting to being out again. I will probably come back and share a bit more of my experience later but overall my experience matches up with yours particularly in the fact that nearly everyone there does not fit the stereotype of 'mentally ill' people that the media and society portray.

I really appreciate your openness on this because so much of the stigma with mental illness is the lack of awareness of its prevalence because people keep it secret and sharing the truth of the experience helps everyone who comes behind us.

[spamflagger]

TBAT: spam at 02:34AM.

[Brin]

Spam #2: Thanks, I'm going to have nightmares tonight.

...okay, I can kind of see that. Especially if you didn't read all the way through. The name and link give you away, though.

(Better than 1 and 3, anyway.)