Let’s go ahead and get this out of the way. I was hospitalized for depression from January 24, 2017, until February 3, 2017.
Eleven days and ten nights in Bryn Mawr Hospital’s Psychiatric Unit.
How I ended up there is probably less dramatic than you think. For the last two years, I’ve been on a medication called Trintellix. When I started working at Roostify, I had to change health insurance. Through an error at the pharmacy, they kept billing my old insurance. Once the pharmacist rectified the error, they informed me that my insurance did not cover Trintellix. I needed to switch. My psychiatrist recommended starting with Paxil. So, towards the end of 2016, I tapered off Trintellix and started up on Paxil with the new year.
The reaction was immediate and extreme. I was incredibly depressed, I had thoughts that didn’t feel like they belonged to me, I was anxious, and I felt like ants were crawling under my skin. It was so bad that I had to take a couple of days off of work. Since having an adverse reaction to a new medication is normal for me, I tried to fight through the side effects. Two weeks later they had not subsided.
So, I started to taper off of Paxil. At first — the side effects went away, and I breathed a sigh of relief. A precipitous drop in my mood quickly followed. It was almost as if I was experiencing withdrawals from the Paxil. Again, I hoped it would pass in a few days. That didn’t happen.
It probably didn’t help that I was (am) incredibly stressed about the state of our world and I had started an anti-anxiety medication that had a side-effect of mildly bumming me out. Up until this point, everything that had happened, happened while Clare was on winter break. Our hope was that these issues would pass before she had to return to school. That did not occur.
We determined that it wouldn’t be safe for me to be home alone. So, we made the only choice we felt we had available to us and went to the ER with the intent of voluntarily committing myself to the in-patient psych unit. Neither of us knew what that meant. We arrived at the ER on Tuesday, January 24th at 9 am.
Checkout anytime you like
The first thing that happened was that I was assigned a buddy, Ron. Ron was the most Philly person I’ve ever met. He told me a story that took place at a WaWa where he was getting a snack on the way to a Sixers game. His job was to make sure I didn’t hurt myself. I didn’t feel like I was an immediate danger to myself, but I appreciated the company since Clare needed to leave for class.
After seven hours in the ER, I finally got word that I was being admitted to the hospital.
As I walked through the big double doors to the unit — I had a sinking feeling that I had made a huge mistake. The nurses had all assured me that it was nothing like what you saw on television. But that wasn’t true.
Large double doors opened up to a large common area. There were three couches in an L shape — with a T.V. off-center playing the news with the sound all the way up. Stage right to the T.V. were three big chairs made out of the same cheap navy blue plastic material of which the couches were made. Two more chairs completed the rectangle of cheap furniture.
There was one long table that spanned from about ten feet behind the couches all the way to a nurses station that was open on both sides. There were two round tables and a small table scattered in the rest of the dining area. I sat down with a nurse named Meghan and went over the policies of the unit. She gave me a brief tour of the floor and brought me to my room.
I got into my room and looked around. Everything in the room was designed to keep me from killing myself. The door to the bathroom was cut at an angle so that you couldn’t hang yourself from it. The shower head was also designed with that in mind. There was no shower rod. Instead, the curtain was Velcroed to the ledge of the shower. That is when it hit me — this psych unit wasn’t designed to help me get better — it was designed to keep me from hurting myself. It was a suspicion that was confirmed over and over during my stay.
My anxiety levels were shooting through the roof. I was trapped.
I laid in my bed — frozen with fear — for the next hour until I heard a voice over the intercom say “Jeffrey, you have a visitor.” I rushed out of my room to find Clare waiting for me in the common area. Strangers packed the day room. I felt like I was on display. There was no privacy, nowhere to talk to Clare where I didn’t feel like everyone was watching me.
Clare would later tell me that I was acting like a caged animal. I couldn’t focus on our conversation — every movement in the room caused me to jump. After about an hour I got enough courage to ask a nurse for my anxiety medication. It kicked in a few minutes later, and I managed to play some ping-pong and then a game of Jenga until Clare had to leave. As soon as I saw Clare to the door, I sprinted back to my room where I hid until the next morning.
I was woken up by one of the techs the next morning saying “Jeff — it is time to take your vitals” my paranoid mind heard “vitamins.” I thought they were trying to sneak me a new medicine.
I stayed in bed.
The tech came back 15 minutes later. “Jeff, you need to get your vitals taken.”
“No, thank you,” I said. “I don’t take vitamins.”
“VITALS,” she responded.
It finally clicked, and I decided to get up.
It turns out that vitals meant temperature and blood pressure. And, around the same time, breakfast was delivered. I sat alone at breakfast and tried not to engage with anyone.
After breakfast, we had what was called a “Community Meeting” which was just a reading of the rules. It became apparent that I was not going to like being here. I took particular umbrage with the rule that you could only go outside if you participated in all of the activities. As soon as that rule was read out, I said, “That is a coercive rule.” The therapist was surprised, and I continued. “Do you agree that getting fresh air is an important part of a person’s mental health? Do you think that prohibiting, for any reason, a patient from getting the sunshine and fresh air could be counter-productive to our goals here?” The therapist stuttered and then continued reading the rules.
I looked around — every patient was watching me, and I recognized that I had called attention to myself in exactly the way I had hoped to avoid.
The upside of calling bullshit on rules that treat adults — adults who were in pain but still adults — as children was that I made friends very quickly.
The pattern continued itself in group therapy where I continued to push back against the stated principles of the unit. For example, we were given a handout that said: “We assume that everyone here is doing their best to get better.” I pointed out that this was directly in conflict with their rules which assumed that their patients were not there to get better.
I came to understand that the therapists were not exceptionally skilled at running group therapies. “Group” was mostly filling out worksheets and only got useful when patients turned them into something more emotional.
By the end of my first day a couple of things became apparent:
- I would get better treatment from the staff if I remembered everyone’s name.
- If I was going to get better, it would be in spite of my situation, not because of it.
- The most important part of getting better would be creating lasting friendships with my fellow patients.
Proposing alternative treatments
One of the aspects that was great about being in the hospital was having access to competent psychiatrists. This was a new experience for me. Up until that point, I had mostly been prescribed whatever drug had been peddled in the office most recently.
I met with my psychiatric nurse practitioner, Christina, on my first day. I made it clear that I was tired of dealing with medications. I had tried a bunch over the years, and between the side effects, lack of efficacy and the unpredictability of my reactions, I was done with the standard options. I asked if there were other options. I had read about Transcranial magnetic stimulation (TMS) and Electroconvulsive therapy (ECT) — both seemed like better options than medication. I wanted to know if I was a good candidate. Christina told me she would run it by the doctor who made those decisions. The next day, Dr. Buroc visited me in my room to talk about doing ECT. He explained the procedure and determined that I was probably a good candidate. If I wanted to do it, the hospital would schedule the first procedure for Monday. I would go under general anesthesia, and they would use electricity to trigger a seizure. The idea is that your brain, like a computer, sometimes needs to be turned off and back on again. I said yes.
My “Transporter” showed up around 9 am to pick me up for the procedure. I was dressed in hospital robes and carted through the hospital.
I got to the room, was given an IV (and didn’t pass out) and then waited. After about an hour I was wheeled into the procedure room. I was trying to stay calm at this point, but my heart was pounding in my chest.
“Take some deep breaths” I heard a disembodied voice say as an oxygen mask appeared on my face.
“Bite down on this,” said another voice connected to a hand holding a rubber mouth piece.
I felt burning in my arm and then next thing I knew, I woke up in a puddle of my own making in the recovery room. The nurse assured me that peeing myself was just a sign of an excellent seizure and handed me my underwear in a plastic bag.
When I got back to the unit, I felt a little wobbly and had a severe headache. I got into the shower, rinsed off and then climbed into bed. Upon waking a few hours later, I still had a headache, but the effect of the ECT was already apparent. My mind was clearer than it had been in years. Part of me was convinced that it was a placebo effect. There was no way it could work that fast. I then decided that I didn’t care if it was placebo. For the first time in 15 years, I didn’t have a monologue going in the back of my head telling me how shitty of a person I was. My brain that used to be filled with lead was now filled with air. The relief was overwhelming, scary and exhilarating all at once.
I ventured out of my room for dinner, feeling like I was experiencing the world for the first time.
Over the course of my stay, a number of incredible people visited me in the hospital. I’d like to say “thank you” to my wife, Clare, who visited me whenever she could, was my constant support and is the greatest partner I could ask for; my father-in-law, Pat, who helped take over some of my household chores and support Clare in my absence; and my friends and fellow POPs (partners of post-bacs) Cat and Ryann, for visiting every time Clare couldn’t. Because of all of you — I had visitors every single night I was in the hospital.
Even more of you wonderful people called me. I think I got more phone calls than any other patient in the hospital. Your friendship and support meant the world to me.
To the nurses and techs who worked at the hospital, thank you for making the best out of a bad situation. Some of you went above and beyond what your job required, and it made a difference.
Most of all, I want to thank the other patients. Most of my stories about my time in the hospital are about the friends I made. I decided not to publish them because not everyone is as public about their mental health struggles as I am. But, you are the biggest reason that I made the improvements I have made. I hope that we stay lifelong friends.