Suicide Watch: Part Three

August 31, 2018

J. Doe is a pseudonym for anonymous contributions to Healers Magazine. The following is the third installation in the five-part memoirs of a brave woman faced with bipolar depression. Click here to read part one, here to read part two, or click here to read part four.


The Ativan did more than take the edge off. I was asleep before we got out of the parking lot and in a strange bed in a strange room in a strange place when I woke up. I was Alice down the rabbit hole, the small Alice. I looked around and the first thing I noticed was an empty bed far away on the other side of an unusually large room. Good, I thought; no roommate. The idea of sharing a room was far from my mind, since I still hadn’t gotten past the idea of being alive. But I’d never shared a bedroom growing up, moved out of campus housing my sophomore year of college so I wouldn’t have a roommate, and gave up my cleaning lady after two visits because being in the house with her was too stressful. Close interaction with a stranger under these discomfiting circumstances was unimaginable—up there with peeing in a closet in front of a stranger.

I didn’t have to imagine for long. When I’d had enough of exploring my sparse room I tamped down my trepidation and stuck my head out the door to look around. The hallway was empty except for a woman sitting behind a counter that had to be the nurses’ station. I gingerly walked over. I doubt I could have walked any other way, courtesy of the Ativan and lingering weakness from my own pharmaceutical contributions. She looked up, recognized me as the new patient and welcomed me warmly. Maybe I’d have patients’ rights here, I optimistically thought—until she gave me my sneakers sans shoelaces because, I silently said along with her, “You’re on suicide watch.” One day of consciousness and I was catching on.

“Where is everyone?” I asked after small talk about how I was feeling (like an alien) and if I needed anything (shoelaces and the key).

“They’re in the dining room,” she said, offering to take me there and introduce me to the other twelve patients. “No, that’s all right,” I said. But she didn’t have to. Hearing a stranger’s voice drew half the patients out of the dining room to see the new girl. They looked harmless enough, which admittedly surprised me. But I surprised them too.

“Dreams Of The Star Children” by Genevieve Esson

“We thought you were black,” a pretty twenty-something girl said loudly across the expanse of hallway as she walked toward me. “I’m Alex,” she offered without a handshake. On her heels was someone closer to my age. “Yeah,” she said, telling me her name was Karen. “I kept coming into our room [our room?] to check on you but only your head was sticking out and you’re so tan I thought you were black.”

I’d always tanned effortlessly and by the end of the summer looked like walking teeth from a distance. That talent is why I was featured in a Latino magazine ad produced by my neighbor in Delaware when I was six, before moving to New Jersey. Whenever people complimented my tan I joked that it was my claim to fame, which maybe it is come to think of it. Until everyone knew my name I was “the tan girl.” When Joe called that night on the community pay phone, to be answered by the nearest person, I was in my room and heard her ask who I was. “The tan girl in the last room,” someone shouted.

The nurse or aide took me into the little dining room with its family-style round tables, introduced me to everyone else, whose names I didn’t bother trying to remember since I was sure I’d be released the next day, and got me something to eat that could have been filet mignon or cat food for all the attention I paid to my plate. This was worse than my first day of first grade—there was no kindergarten in my Wilmington district yet—when the male principal patrolling the cafeteria ordered me to eat my lumpy mashed potatoes. Terrified, I wanted to appease him but couldn’t. Lumpy potatoes were absolutely not on my very short list of edible food.

“If I eat them I’m going to throw up,” I told him, an unchallenging statement of fact.

“Well you have to eat them,” he said. So I did. And I threw up. That trauma started my first-day-of-school tradition of throwing up before I left home. The seeds of anxiety, inferiority and the expectation of humiliation had been sown and are still being reaped.

That Halloween they were in full bloom. My father had put his engineering skills to work to create costumes for my sister and me that topped even my monarch butterfly wings of the year before. I was a color TV—new technology we didn’t have at home yet—replete with the preening NBC peacock on the screen in front of the crepe-covered box that encased me neck to knees, skinny arms sticking out awkwardly on each side. Being younger, my sister had to settle for black and white, age finally getting me somewhere other than in trouble for being a bad influence.

Was it my fault that my only sibling to date happened to like the taste of moth balls and cigarette butts? I remember sitting on the closet floor with her when we found the box of moth balls. One sniff was enough for me but she liked the smell and chowed down on the round white pellets until she was whisked away to the emergency room to have her stomach pumped. When it came to the cigarette butts, all I did was bring a full ashtray—parents smoked in houses back then—into our secret closet. I touched my tongue to the ash end of a butt, spit and warned her that it tasted terrible. So she ate the rest of them. This time she didn’t go to the hospital but I remain under suspicion because she insists I fed them to her. That’s not how I remember it, but it does sound like me.

Regardless, I wasn’t even home when she shoved a pearl so far up her nose it had to be removed in the emergency room. That should have convinced my parents that I hadn’t coerced her the other times either. She was just kind of an idiot as a little kid. Or maybe she was a genius, because both times she came home with congratulatory lollipops while I lay on the couch paralyzed with fear that she would die. Congratulations for eating poison and sealing an air passage with a foreign object?

I expected my congratulations to come at the local Halloween costume contest that same traumatic first-grade year.

TV sets were unique amid the witches, devils and skeletons. Despite the ingenuity of one girl’s costume—a hospital bed with a hole for her head to pop through onto a pillow—my costume was more unique. Why? Because I barfed all over it just as I was about to climb the steps onto the makeshift stage, adding an unidentifiable color and unmistakable stench to my peacock’s plumage. I was stunned, upset about ruining my father’s masterpiece and confused about what I was supposed to do next. Caught up in the flow of kids I was forced onstage—and quickly hustled off when the judges got a whiff of me. I didn’t win a prize and was officially dubbed “high strung.” Duh.

Everyone seemed like old hands at this psych ward stuff and some were downright jovial. Friendships had been forged and everyone except me and a couple of far-gone lost souls knew everyone and everything about the place.

This was a small women’s-only ward, affectionately referred to by its denizens as “crazy light,” the “crazy heavy” ward being downstairs in the adjoining building that shared a small, fenced-in yard with us. All these acclimating facts came at me fast and furious. Almost everyone I met wanted to share, wanted to make me feel as at home as they did, though the average stay is about a week. The two who kept to themselves seemed incapable of social interaction and fortunate to put one slippered foot in front of the other. My special efforts to smile broadly at them and say hello elicited no reaction. With everyone else I found myself getting sucked in, my guard down and my inherent friendliness rising to the surface. Underneath, the other me was chagrined by my stupidity and kept a running dialogue going. Why am I alive? Why am I here? How do I get out?

As nice as everyone was, staff included, there was plenty to dislike about the place, I learned over the next five days as I wandered around the ward bored out of my mind. (I was evidently the only one who thought I’d be there one night.) But there were some positives, too, the best being the total lack of bullshit. When you spoke to someone for the first time you skipped the small talk about where you came from, what you did for a living, whether you had kids and all those other cocktail-party bromides so prevalent in the outside world. You stripped away the bark and got right to core of what mattered in this context.

“So did you try to hurt yourself?” you asked the person behind you in line or next to you at meals. No one shied away from the question. A bunch of us were wearing bandages anyway so it would have been ludicrous to say no. Then you’d tell your story. Not everyone had tried to commit suicide, at least not right before their current hospitalization. Only one other patient had never been on a psych ward, but they’d all hurt themselves in one way or another, whether it was abusing alcohol and drugs, self-isolating, refusing medication or behaving strangely enough to land them in hospitals.

My roommate was a drinker. Like so many other drunks and druggies in places like this she was apparently self-medicating for underlying mental illness, in her case bipolar and anxiety disorders. By her tally this was her twelfth stay in this hospital alone, and she was only in her early forties. Before her current admission she’d made a half-hearted attempt to hang herself but fell from her closet door and hit her face on the dresser. The only damage was a black eye. By the second day we both thought that was hilarious—as if I had done better.

Karen’s husband didn’t know about her little mishap but he wouldn’t have laughed along with us. He was already so fed up with her many slip-ups and their impact on the kids that he called the hospital with a threat: She couldn’t live at home with their two sons until she’d been sober for a year. She couldn’t go on the family camping trip the following week, and he refused to visit her in the hospital. Under the circumstances, some of which she shared with me, his conditions didn’t sound alarmingly unreasonable, but after he gave her the news she stormed into our room, smashed her fists against our thick window for a scary five minutes, and wailed loudly enough to make the downstairs patients think they were hearing voices again. Then she attacked the wall. Thrust into the role of jailhouse lawyer, I calmed her with assurances that he couldn’t unilaterally decide to kick her out of her house or keep her away from her boys. The social worker concurred, so Karen took her night meds and fell asleep mid-sentence.

When I called her a couple of weeks later as promised, she said her husband had allowed her to go on the camping trip after all. “How did it go?” I asked optimistically. “I was bad,” she admitted without a trace of sincere contriteness. “I hid beer in the woods and kept sneaking out to drink it.” There was something like humor in her voice, reinforcing the gut feeling I had from our superficial conversations in the hospital that she relished the negative attention and the drama she created, and saw her psychological problems as a convenient excuse to be “bad.” She ran out of her discharge meeting crying hysterically to me that her doctor was taking away her Klonopin, an addictive anti-anxiety drug that she said was “the only thing keeping me together.” I muttered something encouraging about how she must be getting better if she doesn’t need Klonopin anymore, but she wasn’t a listener; she was an addict.

Until my own addiction to suicide kicked in I thought she didn’t want to change and that the regret she expressed for hurting her boys was just lip service. Now I wouldn’t dare be so judgmental, though I’d still have to bite my tongue to stop from laughing at the notion that Klonopin or anything else was keeping her together.

Nothing was keeping me together either, and the fact that the non-addict bipolar patients had also been hospitalized before didn’t bode well for my future togetherness.

If I didn’t get sick from ridiculously small amounts of booze I might have become a drinker to take the edge off the social anxiety that had been steadily intensifying to the point that I’d stopped going to parties and group gatherings for the most part. It crept up on me. First I lost the little ability I’d had to come up with mandatory cocktail party banter. My mouth moved but my discomfort was sometimes paralytic. If I had the attention of two or three people I froze, unable to say another word. I sloughed it off as premature senior moments, but it undermined my confidence and made me feel vapid. Everyone else would be chattering away, making it look so easy, while I, known as a big talker, watched in amazement and latched onto whomever I felt most comfortable with or someone content to have the floor to herself while I hung on every word.

Next came avoidance. I’d accept an invitation or initiate plans during a moment of sociability and start back-pedaling the second I hung up the phone. My heart sank at the prospect of having to go wherever it was, or having people over. As the date approached I’d start lining up a litany of excuses for not going. I had a headache, I’d tell Joe. I’m getting a cold. My stomach’s upset. I sprinkled enough “shows” among the “no-shows” that he didn’t seem to catch on, and I was afraid to tell him the truth. A good-time guy, he expected me to be the same old good-time girl he fell in love with.

Then it got worse. I couldn’t stand the idea of having to be somewhere at a given time and place—not even to ride the horse my friend so graciously let me think of as my own, a dream-come-true. Doing something spontaneous was different, especially something only marginally sociable with a focus other than talking, like going to the movies or watching the Super Bowl. Command performances, however, filled me with despair and disappointment in myself. I could usually meet the demands of the situation on the outside, but the price I paid on the inside was self-consciousness, self-loathing, anxiety, awkwardness, feeling like a failure, and a sense of being outside myself and the scene—and wanting to stay there.

A couple of years later, after I’d started therapy with Mal, I confided all this to Joe. He was understanding while still coaxing me, sometimes successfully, to go out or have people in, for my own sake as well as his. When I couldn’t or wouldn’t, I’d feed him excuses to use on my behalf. He was a good sport about it, always coming home to report how much I was missed. “That’s nice,” I’d say, thinking, “Yeah, right.”

It took a while for me to start leaking the truth to people close to me, and even then the most I’d usually say was that I didn’t like parties or had been feeling overwhelmed lately and needed time to myself.

After a bombshell like trying to kill myself, other revelations seemed minor enough to share. Both the former and latter shocked even my closest friends and family members, who, except for my children and parents, were the only ones I told or allowed Joe to tell. One of my oldest friends, who lives in Brooklyn, sent a moving email about his love for me and how he was crying while writing. He also said he couldn’t even imagine my name and “suicide” in the same sentence. Why would he? Cousins on Joe’s side of the family who had moved recently from California and immediately became like sisters and brothers to me were stunned when I nervously told them in person when I got out of the hospital. One burst into tears, saying she just couldn’t understand it and making me promise I’d never do it again, which I readily promised her but not myself. Her sister, whose fifty-eight-year-old husband was the one I loved but couldn’t mourn when he died of cancer six months earlier, was clearly upset but must have been furious with me for wanting to die when her husband wanted so much to live. Months later I pressed her to express her anger; in her gentle way she did, but said it didn’t affect her love for me. She was soon dead too, after slipping and hitting her head in the shower, going to bed and never waking up. She wouldn’t have wanted to trade with me unless her husband could have come too, and no way was I worth two people.

Before my attempt I did think about the potential impact on all of these people, but this wasn’t a conscious, rational decision I was making. I was following orders, something apparently understood only by the two people I know who tried to commit suicide. You do it because you have no choice. It’s easy for me to see why that’s so hard to understand from the outside. You had the choice of doing it or not doing it, and you chose to do it, people logically conclude. I can’t explain why to anyone’s satisfaction, but they’re wrong. It’s possible to know what the choices are but find it impossible to choose. When that happens, whether it’s about choosing between two paint colors or choosing to live or die, someone either chooses for you or something happens that forces your hand, like discovering that one of the paint colors has been discontinued. Something forced my hand.

I did tell my daughter and son the bipolar part the first time I saw them after being diagnosed. Neither seemed surprised. In fact my son’s exact words were, “I’m not surprised.” This is what I get for having a daughter with a neuroscience degree and a philosophy-major son who planned to become a psychoanalyst.

I didn’t want to delve too deeply into why they weren’t surprised, not sure I could handle negative perceptions of my parenting. I had already found a stream-of-consciousness essay my daughter wrote in high school in which she said she thought I might be crazy and hoped I didn’t end up in a mental institution. Her rationale was that I’d been yelling a lot lately, which was true. She and my son had been ganging up on me, rolling their eyes at each other as if everything I said were ridiculous. Maybe if “don’t be ridiculous” hadn’t silently dangled at the end of so many of my mother’s retorts I would have recognized typical teenage behavior when I saw it. Instead I took what was probably my childhood frustration out on them. Reading the essay years later, when it fell out of a book in her room, I was struck by my daughter’s astuteness or prescience, but Mal benevolently pointed out that most sixteen-year-olds think their mothers are crazy. And sometimes they are.

Still, I apologized for times in the past that symptoms I didn’t know I had may have negatively affected them. I specifically mentioned the difficulty I had accepting the natural growing-up transition away from me and toward their peers. I took it as a betrayal. I knew better but that didn’t stop me from feeling extraneous and rejected. I do have a little trouble with rejection.

Caught up in my own foggy head, it didn’t occur to me until weeks after my overdose to ask Joe to fill in the blanks about the post-Ativan, post-arrival period at St. Catherine’s. For instance, where had my clothes been when I was in the ICU at the first hospital? What did he remember about the psych ward? What was I like while there? I had no big picture in which to place myself, merely pixelated pieces of a puzzle I couldn’t put together. In essence I wanted an objective case study of myself.

Understandably, Joe had been too caught up in the maelstrom of drama and confusion to remember much himself.

“Geez,” he said when I finally did ask. “It’s all kind of a blur.” I was wearing my clothes when I left in the ambulance but he didn’t know where they’d been hidden or how they got on me. He remembered getting lost the first time he came to visit and being told by two guys to “go down the hill and take a right at the bull,” a statement that added to the surrealism, though there really is a big green bull sculpture at an intersection in Smithtown. He also remembered meeting my roommate. And then, the only memory that really mattered:

“I remember you were the prettiest patient.”

The understated sweetness of those words seeped under the door I’d closed between myself and the world everyone else seemed to be living in. It’s not like he hadn’t told me scores of times in the thirty-three years since we’d become friends that he thought I was pretty or looked nice that particular night, but this touched me in a deeper place. It was more than a compliment; it was an acknowledgement that I could still touch him. That’s something I’d doubted in recent years when we’d often misplaced our love for each other, struggling independently to overcome old resentments that remained roadblocks only because we didn’t know how to remove them with words long after the reasons for them were gone.

The magnitude of what I’d done shook him to his core, where he rediscovered what he called his wellspring of love for me. He told me this on our beach, where he also read aloud passages from a book about coping together with bipolar disorder. I didn’t doubt his sincerity and felt a connection that had been missing except through the kids as conduits. I knew he was being honest, yet I couldn’t completely trust this turnaround. When a wonderful friend of ours was bravely dying of cancer I vowed never to complain about trivial problems again, and when she did die I knew I could never drive by her house without reliving the gut-wrenching pain of her loss. But life has a way of working around convictions and avowals, enabling or causing us to concentrate on ourselves again. Without noticing that anything has changed, losing your keys is once again a tragedy, and you whiz by your friend’s house with no more than a twinge of regret. I was aware of this knowledge hanging over us like an omen.

Joe made the long drive to the hospital every evening, bringing me belongings he knew I’d need, mainly my beloved L.L. Bean Wicked Good slippers so comfortable they make me sigh on sight, and sweatshirts and sweatpants. My exterior had to be comfortable to counterbalance my inner discomfort. Whatever was brought in had to be inspected by a staff member—not a concern, I thought, considering how meager my requests were, but I was mistaken. A vital part of my limited wardrobe was confiscated: the drawstrings that held up my pants (suicide watch). The frustration of constantly keeping them from falling down around my knees made me give up. The air conditioning was too cold for shorts so I lived in the only pair of sweatpants I owned with an elastic waistband, which was fine with me. I craved familiarity.

I was determined not to be one of the two or three patients who spent night and day in their pajamas. They made it impossible for us to pass for normal when we were herded into the industrial-sized elevator with concerned-looking outsiders who sized us up and made accurate assumptions as to what we must be. I tried to stand apart and look as perplexed as they did by people wearing pajamas in the elevator in the middle of the day, but then I’d follow a stranger’s eyes downward to my laceless sneakers and face the demeaning truth that these were my new peers. Once you stopped fighting reality it was pretty funny actually—a bunch of young to middle-aged women huddled together, pants falling down, shoes falling off, pajamas crying out, “Yes, we’re from the psych ward.”

It was straight out of a hilarious scene in a book by Amy Wilensky: Passing for Normal: A Memoir of Compulsion. Some members of her new Tourette’s Syndrome support group had gone out for a drink after being invited by a professor who considered them and himself as behaviorally superior to the others. When the waitress asked where they’d like to sit, the author automatically pointed to the back of the room. “After all,” she wrote, “there were hooters and screechers among us.” But the professor insisted on a table in the center of the room, convinced that this well-dressed party would pass for normal in a room full of normal people. They ordered “amid a low-pitched chorus of vocalizations and a frenzy of tics,” she wrote. The professor was oblivious. “I know this is going to sound elitist,” he said, “but I feel so much better in this group than the other one.” Meanwhile, the author glanced around the room and noticed other patrons eyeing them openly. “The professor, in particular, had a distinctive hoot,” she noted. Next to her a couple raised their eyebrows in unison, and a woman made circles at her temple with her index finger, the universal sign for crazy.

No one on the elevator did that to us but I could feel their index fingers twitching. The belief in one’s symptomatic superiority is meaningless when you’re all lumped in together. Just like in school, the lowest common denominator rules. And who knows? Maybe I was it. Who else pauses while killing herself to write a thank-you note?

That non-fatal error and self-chastisement didn’t totally diminish my ingrained role of caretaker and overseer. During my third night, when the rest of us were having our drug-induced dreams, a teenager supposedly under the minimum age for this ward had been sent up from the emergency room. Word spread that she’d voluntarily gone to the ER with her parents just to talk to someone but was deemed a danger to herself and not allowed to go home. She came to breakfast in her hospital gown, looking dazed and disheveled. I sat next to her and said hi. She murmured something I couldn’t hear, then stared at her plate without moving until we heard a commotion in the hallway that sounded like an argument. A moment later her distraught parents were standing in the doorway. The new girl showed no expression as she stood and shuffled toward them.

“How are you feeling, honey?” her mother asked.

“Okay.”

“Don’t worry. We’re going to get you out of here.” On the word “here,” her voice broke and she sucked in a sob.

“I want to stay,” the girl said, almost assertively.

The noise of breakfast cleanup obliterated the rest of the conversation, but when I headed back to my room the parents were face to face outside their daughter’s room, talking heatedly. They turned toward me, staring like deer in headlights. The mother was crying but stopped as I approached. The father nodded absently. Seeing their pain I smiled sympathetically, and before I knew I was going to say anything, said: “Don’t worry. We’re not crazy in here, and some of us are mothers. We’ll watch out for her.” Silence. I don’t know who I thought I was, and neither did they.

I was feeling oddly serene that morning. Shortly before waking up I had one of those dreams whose feelings linger beyond sleep. They’re usually bad dreams, and this one started out that way. I was on a plane, traveling alone, when it plummeted a few thousand feet in a matter of seconds, throwing everyone into a panic. The oxygen masks came down but were swinging too wildly to get a hold of as we started spiraling nose first toward the ground. In the slow motion of dreams I had time to assess the situation. With preternatural calm I acknowledged that we were going to die. It was an absolute truth. We would pick up speed and death would be instantaneous and painless. I realized with complete clarity that fear comes from resistance, and resistance comes from uncertainty—the possibility of a better outcome worth fighting for. With absolute truth came absolute peace. I felt no fear, and spent my last moments marveling at that. I woke up convinced that once the inevitability of death becomes clear, any fear will evaporate. That’s what happened to me and I hoped it would happen again the next time I was in that position.

For now it was the inevitability of life I was dealing with, though, and the fear wasn’t evaporating; it was growing. I was afraid that every day would bring another denial of freedom, and if there’s one thing I learned about myself on the psych ward, it’s that limbo isn’t the best place for me. I was stuck there, mostly just milling around, neither being mistreated nor treated. A circumspect female psychiatrist stopped by briefly every day but only to assess my status and ascertain if I’d kill myself when I got out.

My score on some sort of suicide rating system made her leery of my assurances that I was fine now. I don’t remember the exact numbers but my attempt was way up there in terms of seriousness, like twenty-nine out of thirty. I had a well-thought-out plan, an isolated location, a lethal stockpile of pills and a note written ahead of time. I had refused to make a pact with my therapist not to hurt myself, was detached from what I’d done, told the doctors who committed me that I didn’t regret it, was biochemically driven by manic agitation, and so on.

She had me there, but that didn’t stop me from trying the cell phone defense again. She looked amused—not what I was going for. In fact that and my attempt to convince her I wouldn’t have stopped to write that sappy note if I’d been so intent on killing myself, backfired. It was my light tone she homed in on like a psychiatrist. A person who tried really hard to kill herself should not talk about it so casually, as if it had happened to someone else. She was a tough crowd.

I was fraught with anxiety about being a captive, bored to near-death by the lack of stimulation, (including caffeine, lest it launch anyone into mania or revolution), wandering aimlessly like a Jew in the desert for forty years, waiting, waiting, waiting to be called home. It became an obsession that even coloring in the art room couldn’t dislodge. Every day that the tight-lipped doctor refused to tell me when I’d be set free made me more anxious until I was approaching the unbearable agitation that drove me to overdose in the first place. I hadn’t cried out of sadness in ages but had no trouble sobbing in self-pity.

There was simply no reason for me to be there. I was done with suicidal ideation for the time being and felt just plain weird, like I’d been plopped into a family of aardvarks. I couldn’t concentrate to read or do the New York Times crosswords Joe had brought me. I fared better with Sudoku number puzzles, probably because there were no words to interfere with the ones in my head telling me over and over that this was torture, and asking why torture was better than swimming, boating, napping on the beach and the other pastimes I convinced myself I’d enjoy again once I got out. Of course as my real psychiatrist noted after I did get out, I wouldn’t be enjoying those things if I’d been dead either. True enough, but being dead I wouldn’t have been in a hospital lamenting their loss.

While well-intentioned and not the horror show anyone who hasn’t been there might imagine, a locked ward can force the very self out of you, especially if that self is genetically predisposed to rebel against injustice—in this case being kept anywhere against my will. I get that from my father, who is famous or infamous for scathing, well-written letters to the editor of every paper from the hometown weekly to The New York Times. If I hadn’t concealed what I’d done to myself and where I was, maybe he would have taken up my cause. On second thought, the first time I was depressed and suicidal after college, he told me I had always been too introspective and to snap out of it. In his defense, that was long before clinical depression became part of the lexicon of the masses.

I plotted my escape most waking moments, but by the time I saw a sure-fire opportunity I’d already been told I would be going home the next day. Besides, what if I was wrong about how fast I could run without shoelaces, or the police issued an all-points bulletin, complete with an unflattering picture of me, warning everyone to be on the lookout for an escapee from a mental institution? That thought seemed far-fetched at first but I swear it’s what kept me rooted in place the day I found myself last in line with no supervisor behind me on our way inside from an outdoor break. I was so close to the parking lot that I could have walked slowly backward and been long gone by head count.

The lack of therapy made the ward nothing more than an oversized cell, and fresh-air breaks were nothing more than smoking opportunities that nicotine addicts embraced in a carpe diem sort of way. They seized every day exactly three times. They knew how to make the most of the little they had to look forward to, and what they had were cigarettes, dispensed three at a time at the nurses’ station like meds, and lit outside in our fenced pen by one of two friendly aides who ushered us there and guarded us while fresh air was displaced by the stench of thirty chain-smoked cigarettes.

What I had instead of cigarettes was a tiny patch of grass bordered by shrubs and flowers where I walked laps so tight I got dizzy, made worse by fumes from smokers who planted themselves on my turf. But at least it was exercise and I could sit briefly on a bench and raise my face toward the sun. Its warmth and initial sting would zap me like electro-shock therapy into a sense of wellbeing—a false sense, I know, considering the health risks. Then again, who cares? I’d been bitten through the finger by a monkey in a cage, knocked momentarily unconscious on a haunted hayride by the Headless Horseman’s head (a plastic pumpkin at the end of a rope), and chomped on by someone’s pet pig at a tennis court. You never know what’s going to get you in the end, unless you orchestrate it yourself.

I usually walked my grassy beat alone during fresh-air breaks—a blessing considering the space and my intermittent social anxiety—but the overall atmosphere was collegial and I wasn’t friendless. We were all mysteries trying to solve ourselves, looking to each other for clues. None of the seven or eight of us thirteen or so women who loosely banded together hesitated to ask or answer probing personal questions that might shed light on ourselves. We were like planets caught in the gravitational pull of something huge and amorphous, and we wanted to know what and why.

I can’t say it was comforting to find people like me because I didn’t know what “like me” meant. But while our ages ranged from young enough to be my daughter to old enough to be…well…me, there were at least four things we had in common: We’d physically hurt ourselves at some point; we were all on meds, obediently lining up twice a day to swallow under surveillance the pills in our tiny cups; we had all exhibited behavior deemed too inappropriate for the outside world; and we each supposedly had diagnoses that included bipolar disorder, making me wonder not for the last time if this diagnosis du jour were being doled out too freely.

I wasn’t unique at all, except that I’d finished college and had a successful career while most of their lives had been interrupted by mental illness in their teens, mid-college or early in their own attempted careers.

The only patient aside from me who had never been on a psych ward before was a young Indian-American woman whose accent was so thick everyone else had stopped talking to her. It was uncomfortable for me too, but I kept finding her next to me at meals and on the meds line so I had to try. She was roughly the same age as my daughter, which meant I couldn’t abandon her, awkward silences or not.

“Did you try to hurt yourself?” I quietly asked her one night, making a wrist-slitting motion, though she wasn’t cut or bandaged. She looked up at me smiling shyly and said, “Yes,” followed by a long string of apparent words. By the time she left all I knew was that she was a first-timer, had tried to hurt herself, had a two-year-old and came from India. Her parents, daughter and brothers were there for every visiting hour, and the night before she left her father brought us half-gallons of ice cream plus toppings—a  gesture of normalcy with sprinkles. It would have taken a fresh-air break to pry the population away from this. I wish I could deny diving in there with my own plastic spoon.

Amy, another girl I bonded with, was in her seventh semester of art school when a new doctor at the clinic where she was being treated for depression inexplicably changed the medication that had enabled her to live a relatively regular life. Within days, this beautiful, vivacious, enthusiastic person was so debilitated she barely got out of bed for four months, until another doctor put her back on the old antidepressant and restored her personality. She had been in St. Catherine’s before and said she considered her stays to be vacations where she was coddled by the kindly staff.

Patients I’ve met who are reliant on public healthcare say that continuity of treatment is uncommon. You see whichever doctor is there that day, so a stranger often wields power over your wellbeing with the illegible stroke of a pen on a prescription pad. This doesn’t mean the physicians aren’t caring and competent, but if they don’t know you, how can they detect subtle changes in your condition that can be ominous or positive? A private psychiatrist or therapist who is aware that last week you talked constantly and this week are silent is often a luxury reserved for the well-insured and those who can scrape together or easily afford upward of one hundred fifty dollars per session.

Still, getting help is possible whatever your income. I know people who pay nothing to see private psychiatrists and therapists, either because they’re on Medicaid or live in states that provide care on a sliding-scale basis. They also get free or almost-free prescriptions. Drug manufacturers may also help people who can’t pay, and doctors sometimes hand out free samples. In addition, federal law now requires group health plans to provide equitable benefits for biochemical mental and “physical” disorders. The problem is that hardly anyone knows about the Mental Health Parity Law—something the second President Bush finally got right. Another problem is that so many people with mental illness can’t hold down jobs and therefore don’t have company insurance that would provide these benefits and offer continuity of care.

There are also support groups, some led by therapists, that don’t offer formal treatment but at least get you out there among people, talking or just listening. The similarity of experiences and dedication to getting better is in itself comforting. Less intimate but also potentially helpful are online support groups for whatever ails you. Not long after I’d been diagnosed I searched online under “bipolar support group” and found a bunch of them. Vulnerable, alternately suicidal, highly agitated and hyperenergetic, I visited one and started reading posts. Members were obviously enthusiastic to share their stories about being in and out of hospitals, their long lists of past and present meds, the impact of illness on their relationships, their suicide attempts, and what helped or didn’t help them. A quiet desperation came through loud and clear. There were also a lot of questions about symptoms and meds, with responses from other members who, for the most part, shared information but were careful not to give advice. That shows great restraint, I thought—the tendency of most of us being to jump right in with words of wisdom intended to steer someone in one direction or another. We tell each other to avoid this restaurant, doctor, teacher or plumber and use this shampoo, buy this stock, read this book or stay at this hotel. The reason they didn’t do that, I speculated, is that anyone who’s undergone years of therapy is much more tentative about making pronouncements, knowing as they do how precarious life can be, how suddenly the earth under your feet can crack open and swallow you whole. Certainty is impossible when change is your constant.

By then I’d been on lamotragine (generic Lamictal) for a few weeks. I got it from an online Canadian pharmacy at a fraction of the best price I could get it for locally, including superstores offering hundreds of commonly prescribed generic drugs for only a few dollars but charging regular prices for other medications. Later I later found it for much cheaper at Costco’s online pharmacy.

My first post on the support group site was in response to a woman who needed to find affordable Lamictal. I wrote that I had shopped around and found the best deal at this particular Canadian pharmacy. The next morning I returned to the site and was greeted with this response to my entry: “Beware of [my ID]. She works for the manufacturer and only cares about promoting their drug. People like her should be exposed and banned from the group. Ignore anything [my ID] writes! She’s evil.”

This is support? Despite being a little scared that a bona fide insane person had it in for me, I felt so sorry for myself I had to reply. “I can’t believe I came here for support and was attacked for trying to help someone,” I wrote. “I don’t work for a drug company and if I did, why would I tell someone to buy Lamictal manufactured by another company in another country?”

“Ha! Methinks thou dost protest too much,” came the immediate reply. “No sparkles for her.”

Sparkles…I decided to find a different support group.

That afternoon I got an email from a member who had read our exchange and took well-deserved pity on me. “Don’t worry about [his ID]. He gets excited sometimes but he’s harmless. I wrote to him and told him he was wrong and he feels bad about what he said.”

My first thought was, how did she get my email address? (I had apparently checked the box allowing direct communication when I registered.) I wrote to thank her and ask what sparkles were. “They’re like gold stars. It’s his thing.”

A little later I got an email from the sparklemeister himself saying: “I know you don’t work for the drug company and I told everybody it’s OK to talk to you. I’m sorry that I thought you were one of them but you have to be careful.”

True to his word, he had posted a retraction—and given me sparkles.

Amy said she was looking forward to going back to school when she got out, but best intentions don’t always translate into action when mental illness erodes self-determination.

My third night there, she whispered conspiratorially to Karen and me that she wanted to talk in our room about her boyfriend. With all of us in our pajamas, sitting on beds giggling about sitting on beds in our pajamas giggling, I felt thirteen even though I was the oldest at fifty-three, Karen was forty-two and Amy, twenty-three. I had a daughter older than that, but she never sought my boyfriend advice so I listened attentively to Amy’s plight involving a nineteen-year-old guy she met in rehab who lived three states away and bored her to death when he called twice a day. Should she blow him off or keep him on hold just because she wanted to stay his friend? I resorted to the therapeutic technique I learned in college called active listening; you reflect what the person has said and ask questions. “I’m so stressed that I don’t know what to do,” she might say, to which I might respond, “It sounds like you’re anxious and confused,” and she ideally would be encouraged to share and examine her feelings. I wanted to remain non-committal and not risk ruining her life by expressing my opinions. What did I know? I was on a psych ward. I could see why my daughter sought advice elsewhere.

On the fourth day, I have no idea what I did differently but I was called to the nurses’ station and unceremoniously handed back my shoelaces. I was no longer an “involuntary” on suicide watch, though the difference between being voluntary and involuntary didn’t seem to mean anything in practical terms since I couldn’t opt my way out the door. But I began to smell freedom, and the psychiatrist I immediately grew fonder of confirmed it. I’d be discharged the next day.

My version of euphoria lasted right up until she recanted that decision, making me sorely regret passing up my big chance to escape. She changed her mind after making Joe read her my suicide notes over the phone. Until then she hadn’t known that I’d written my fancy goodbye card two weeks before my attempt, indicating the kind of careful scheming frowned upon by her profession. The misguided spontaneous note penned at the beach was less worrisome. My efforts to convince her that I shouldn’t be penalized for being an excellent planner made her smile but that’s it. My teary, sincere claims that boredom was driving me out of my mind didn’t move her either. I was punished with another day to contemplate the seriousness of what I’d done. I spent it contemplating what to do to her with my shoelaces.

Why she considered spontaneous suicide preferable to a well-thought-out plan was a mystery to me. It’s not as if I dispassionately picked a day and time to do it, like scheduling a haircut. I simply had a plan in place in case I did need to act spontaneously. I guess the rationale could be that prolonged strategizing requires a level of emotional detachment that makes the act itself almost academic. Or, as Dr. Fink later explained: “Somebody actually taking the time to plan it out is usually more serious. This isn’t something that just happened.”

My discharge plan—a form specifying meds and follow-up care—called for me to go directly from the hospital to Dr. Fink’s and then to Mal’s. There was also the name and number of a support group that turned out to be defunct.

“I guess we have some things to talk about,” Dr. Fink said calmly when he called the day before my release to confirm our appointment. “Yeah,” I agreed. “I guess so.”

Joe picked me up the next afternoon to a warm send-off by my mental compadres. As we headed toward Dr. Fink’s office I felt like I was breathing air and seeing sunlight for the first time. My mood was lighter than upbeat—excited, I’d say. Expectant. Post-suicide attempt and post-psych ward was new territory in a brave new world. I wasn’t thinking ahead to who I would tell, what I would tell them, how they would react or how they would treat me afterward. My paramount thought and reason for levity was that I’d never again have to live with unremitting despair and agitation. I wouldn’t wait that long.

 

 


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