Sunday, November 25, 2018

I was hospitalized (part 7)

Continued from previous entries: firstsecondthirdfourth, fifth, sixth

Content warning for psychiatric hospitalization, thoughts of suicide, anxiety, self-harm, and overall depression.

The "poof" aka a giant cat bed we bought to use for a couch.
Once home, I would spend the next two weeks lying on the poof (see above), watching Steven Universe, and occasionally joining my husband for drives around the city in his new company car. Spending time with him just chatting and driving was the best part of it all. Okay, spending time cuddling my cats was pretty great too. I had missed my little family. I was still scared of the future, but being home felt good again. Knowing what it was like to be away from it all made me value everything a little bit more than usual.

Back when I was 15 years old, not long after I was first seen for psychiatric care, I learned how to lie to doctors. Pretending to be fine was easy. I knew what the "right" answers were. "In the past 2 weeks, how often have you felt depressed? (Rarely)" "In the past 2 weeks, how often have you thought about harming yourself or others? (Never)" You might wonder: if I wanted help and knew I needed it, why would I lie? Why would I hide my injuries after harming myself if it's a so-called "cry for attention"?  (It isn't, necessarily, but that's a whole other blog post.) Why did I still sort of want someone to catch me, to stop me? Depression causes me to view my loneliness as my correct default state of being. I'll believe I deserve to feel that way. I deserve to hurt. After Walden, I had new reason to keep it all to myself. If I told anyone how I was still feeling, would they send me back? This was and has continued to be a fear of mine. I was miserable.

For a few months after being discharged, I wrote in my journal frequently, using the same Composition notebook I'd gotten while inpatient. I wrote a lot about my fear of going back to work. I used Gabapentin as needed to get through the worst of the anxiety. I still couldn't stand the thought of cooking and didn't have much of an appetite, which had been an issue for a while before the hospitalization. That was part of the reason that I'd been prescribed Remeron in the first place, since it can stimulate appetite, though I hadn't lost any weight. I contemplated seeking out longer-term inpatient hospitalization to get away from life for a while, though I was very aware that would just be running from my problems. Figuring out when you're just avoiding dealing with a problem and when you're taking a needed break can be really difficult. I avoided my family too. I felt too raw and I knew that the sympathetic looks I'd get would be really upsetting. Being isolated felt more secure. Ultimately, spending more time alone probably helped me feel calmer and give me "space" to think.

The best thing that came from my weeks off from work were figuring out a little more of what kind of job I'd prefer (something busy, with an integrated way to track my workflow like a ticketing system) and scheduling self-care. I bought coloring books and markers, which I still have. Admittedly, I haven't used them a lot, but when I do use them, I really need it, and it helps.

When I did return to work after about 3 weeks absent with no notice to anyone except what was protected by FMLA (boss and HR knew what doctor/facility had signed paperwork), nobody asked where I'd been, they just said it was nice to have me back. Either they're all just that considerate or someone quietly told everyone not to ask. The return to normalcy was actually scary because the "normal" I'd been experiencing before contributed to that period of depression, but at least I felt better equipped to ride it out. I was determined to at least stay at the job until I paid off my student loans (which I did!).

The Hunger Games

When the Wellbutrin eventually took effect, I was still fairly depressed, but it became easier to make positive choices that didn't feel forced. I started to feel like being happy, when it happened, wasn't a mistake. I clung to those moments. After some weeks passed, I realized it was possible for me to feel better than I already was. I fully believed I could make it happen. I had to see the crappy psychiatrist one more time because it would be faster than to wait for a new psychiatrist. I went in to the appointment strengthened by the knowledge that I was making the right decision to increase my dose. I knew I could get more out of the Wellbutrin. She put in the new prescription for me, but asked why I wanted to transfer to a different doctor. I told her I understood why she did what she did, hospitalizing me against my will, and that I knew she had to because I'd said I had thought about harming myself (overdosing). I told her that as a result I could never trust her. She started to explain herself again and I cut her off. It didn't make a difference at that point. I'm still amazed I was able to sit through that appointment without exploding or breaking down.

A quick reminder for everyone: do not tell other people how to feel. They are not your feelings to dictate.

Someone once told me I should forgive her, but I never will and I don't feel this reduces my quality of life in any way. I still hate her. I still hate what she did, even though it wasn't that bad and in some ways was beneficial. For better or worse, I know now that no matter how bad things get, I could always be hospitalized. It's reassuring knowing I could go away and be safe from myself and everything. I've told myself that more than a few times in the years sense. At the same time, it's also an internal check to myself. "Do I feel so bad that I want to go to the hospital and get an emergency psychiatric evaluation? Do I think this warrants hospitalization? Do I want take myself away from the people I love?" The answer is always no, so I struggle through another rough day, night, or week, knowing I will find relief eventually. I'm a firm believer in "you'll feel better in the morning" and sleeping off the worst of a bad day. It doesn't fix much, but it helps me to keep going.

When I met my new psychiatrist sometime later, he told me that he would always try to work with me and my therapist to come up with a plan of action before it came to making a decision on my behalf. He helped me finally get a diagnosis for ADD after a lifetime of complaining about fatigue  and poor focus, and figure out the right dose of Adderall so I that didn't feel like my heart was going to race out of my chest. He approved of my use of CBD for anxiety relief when I started experimenting with it and we had a fun rant about the slow legalization of medical marijuana. We had a good working relationship. I trusted him more than I've trusted any other doctor and I've seen plenty for all kinds of reasons. Because of him, I believe that there is a right medical provider out there for everyone, though there's no guarantee that we'll ever find them when we need them or at all. I'm sad that I had to leave his care when we moved from Massachusetts to California. I scheduled appointments in August for November, the soonest I could be seen, with a new behavioral health provider. My former doctor warned me that psych care is scarce out here and it seems to be true.

The last post or two of this series will be some kind of final reflections.

Friday, November 02, 2018

I was hospitalized (part 6)

Continued from previous entries: firstsecondthirdfourth, fifth

Content warning for psychiatric hospitalization, anxiety, thoughts of suicide, and overall depression.
"I'm trying very hard not to think of much outside of here. ... Part of me feels like I really don't belong here, but just being here feels helpful. ... little things like cooking breakfast feel really daunting right now. I have to find a way to operate, but when I imagine myself at home, it just feels despondent. I can't imagine myself happy there right now, it feels fake."
I can't completely blame the Remeron for my depression at the time. Everything in my life during capable of making me feel anxious or depressed. I felt so detached from the world. I felt drained of the ability to handle any kind of stress. That's part of what had lead me to seek out help that summer. Depression can creep in so slowly that you don't notice it. Your brain doesn't suddenly think "Oh, this is an unusual thought, maybe that's not normal." When it creeps in like it did/does for me, you feel like your thoughts are normal, however bleak they may be. Why would you suspect that your own mind is betraying you? For all intents and purposes, your thoughts are you. It took months for me to accept that my life was probably not going poorly enough to warrant feeling awful all the time.

Being in the unit was partially a relief since I didn't have to worry about anything beyond myself. I did have to handle some paperwork early on to make sure the HR department at my job was informed that I was taking FMLA for a medical emergency. After all, I had just vanished and stopped going to work without any reason given. My crappy psychiatrist was even kind enough to put in the forms that I needed 3 weeks for treatment so I wouldn't have to go back to work right away. I didn't have enough vacation time or sick pay to cover the absence, so I missed a paycheck. That was another source of stress that I tried not to think about. How was I going to pay for this? I was sure it wouldn't be cheap.

Little did I know, my insurance at the time was amazing and when the bill arrived a month or two later, I only paid $70.

Most of my journal entries for my stay at the ward are me recording my feelings (because, you know, it's a journal) and my reaction to medication. I remember purposely trying not to write much about other people because I wanted to stay focused on my own health and care. Sadly that means I lost a lot of details. There are some gems in there though. I can see hope peeking through the haze of depression. Wellbutrin takes at least 2 weeks to kick in and since I only started it on my first full day at Walden, I was still weeks away from significant relief.
"I got to go for a walk this morning. It was really nice to get outside for a little. The weather is perfect autumn temperatures, with lovely clear blue skies. The leaves are turning all over the place. I would love to go for a bike ride."
The first picture I took after I got discharged.

I was so angry when I found out I couldn't leave on the third day, Friday. They couldn't discharge people on weekends either. I had to meet with either the social worker or the nurse practitioner for them to clear me and they weren't available. At the time, it felt like the staff just made excuses to avoid doing more work, though I'm sure there were protocols they had to follow. It's also possible the staff I needed to see were really just not available, which makes their lack of resources distressing. We weren't allowed to go for walks on the weekend which further increased my frustration.

At least visitors were allowed. In my journal, I noted every time my husband came to visit. I just wanted to curl up in his lap and sleep. That closeness felt safer and more comforting than anything. He was a beacon of hope for me, knowing that I could go home and return to a life with him in it, if nothing else. The contrast of being trapped away from home and having a peak at freedom with someone I love probably helped me fight to get better over the coming weeks. Some of the other patients saw us together told me we were adorable. Both of my visitors (sister and husband) asked where I wanted to eat when I got out and I had a hard time deciding. I'm not sure I ever picked anything! I think I just wanted a decent burger and fries. If we did go out, I'm sure it would have been to Boston Burger Company.

By Sunday (day 5), I was feeling better about going home and still incredibly anxious about the prospect of my eventual return to work. Prior to the hospitalization, I had started considering looking for a new job. I was dissatisfied with my employment at the time for a number of reasons, but guilty for wanting to leave because the job had great benefits and the work wasn't too hard. That was part of the problem: I was bored and opportunities to advance seemed far away. It wasn't until well after the hospitalization that I figured out how to use the slow pace at work to my advantage. I took my time recovering and started preparing my resume in the winter. I felt confident enough to start looking for something new by spring.
"I tend to feel like I'm not bad enough to warrant help. When I was 15, I just kept wondering if how I felt qualified as depression. I think I did a lot of online quizzes. But asking for help is so hard. Depression lies. I am worthy. Every life is worth. I am not an exception."
On Monday, 6 days after I was hospitalized, I met with the social worker to arrange to go home. Before that, she had given me very little information about what needed to be taken care of so that could happen. Finally, the unit verified that I had follow-up appointments scheduled within the next week or two with my therapist and crappy psychiatrist (until I could be set up with a new one) and I was released! David surprised me by picking me up in his new company car, a 2015 Chevy Equinox.

To be continued...

Monday, October 29, 2018

I was hospitalized (part 5)

Continued from previous entries: firstsecondthird, fourth

Content warning for psychiatric hospitalization, thoughts of suicide, anxiety, and overall depression.

From my journal:
"A few younger girls introduced themselves to me in a line for snacks. ... The way they act reminds me of how I felt when I did partial hospitalization at age 16. It makes me sad that I can't help them. Well, maybe I can, I just don't know how."
Steve Buscemi "How do you do, fellow kids?" from 30 Rock

The first fellow inpatients I spoke to were teens on my first night, while waiting in the snack line. They complimented my hair color and I complimented one of them for their buzzcut. They told me the best snack to request is Rice Krispie Treats and they were so right. I hadn't eaten Rice Krispie Treats in a long time and now they're one of my favorite desserts (she says while she eats one that her husband just made). I started sitting with the younger crowd at mealtimes. They all thought I was close to their age and were initially confused when I said I was married. They were 10 years younger than me.

I always struggle with learning names and this place was no exception. Right now I remember 3 names among the patients: one because she was sweet and wore an Adventure Time bracelet, one because his name was like a common name but with an unexpected twist (think something like "Enjamin"), and the other because she talked. A lot. And for whatever reason, her name is the only one I wrote down! The unit had 24 beds and, once I arrived, they were full until the next patient was discharged. Some patients didn't interact with anyone and mostly stayed in their rooms. Everyone else watched TV, read books, attended groups, and used coloring books.

My sister was sweet enough to bring a coloring book and some awesome markers when she visited. I left the markers behind for the other patients when I was discharged. Coloring was fun and I chatted during those times. If you wanted to be alone, no one bothered you. It was nice to know I had space to myself when I wanted it, something I value highly as an introvert. I always intended to send some decent quality art supplies after I got out, but honestly I still haven't. Blame it on Executive Functioning Disorder.

We were also allowed to watch movies in the evening as long as everyone agreed on one and it wasn't inappropriate. We started watching something that was definitely NOT appropriate as there were scenes with psych wards, but I can't remember what it was anymore. The staff made us turn it off. I finally saw High Fidelity. I hated it. We also watched The Breakfast Club, which still has many relatable themes despite being so thoroughly 1980s. Enjamin had had a rough day and was asked by the staff to write an essay, like it was for detention for his poor behavior. In defiance, he wrote his own version of the Breakfast Club's essay. That kid was awesome. I remember he asked me on a walk if I believed in God. I told him basically I believe that energy comes from something and it connects us to everything. Whether that's a Higher Power or not, I don't know.

We were all at Walden for different reasons. I was interested to hear about other people's diagnoses and how they ended up there. I never pried, but most were willing to share. Some of them had also gone to Bournewood in the past, where I had my partial hospitalization 11 years prior. Some had been hospitalized several or many times before. Some had been in the unit for a week or more, just until other arrangements could be made and had been in this particular unit before. It was only supposed to be a short term measure for personal safety in cases of emergencies. I felt so safe there, surrounded by my fellow crazy people. It was freeing to talk about all this garbage in my brain and my personal history of depression without any kind of judgement, and with people who could relate completely. It made me want to seek out group therapy after I got out, but I never found anything that seemed like a good fit.

The most memorable interaction I had with one of the other patients was being told to watch Steven Universe. I watched all available episodes when I got out and it was incredibly therapeutic. I still love the show and highly recommend it for kids of all ages (yes, even adults) who might be struggling with their emotions.

Other things I can specifically remember:

  • People guessing my age
  • Guessing the age of the 19-year-old boy (I was right, but I told him 21 to flatter him)
  • Getting hit on by the 19-year-old boy while I was floating away on the couch after taking Gabapentin
  • Being too comfortable to care while also highly amused
  • Listening to the 19-year-old boy hit on one of the teen patients (age unknown) and talk about  the blind spots between the security cameras
  • Listening to a few of the teens brag about their rule breaking during previous hospitalizations
  • An older patient with anger issues discussing her discharge plans and wanting to be allowed to see her son
  • A patient my age who heard voices and wanted to figure out the right medication so he could leave and see his daughter again
  • Someone being put on watch for a while in their bedroom (not allowed to be alone) after they made some threats about their self
To be continued...

Thursday, October 25, 2018

I was hospitalized (part 4)

Continued from previous entries: first, second, third

Content warning for psychiatric hospitalization, thoughts of suicide, anxiety, and overall depression.

In the corner of the common area, there was a whiteboard with a schedule of groups and other events, including a time for walks outside if the weather was nice enough. The group classes weren't mandatory (for me, at least), but we were encouraged to attend most if not all of them. I did, just to pass the time, and found some interesting though not particularly helpful. The only attendance that I think was mandatory was the morning and evening goal check-in where we set a goal for the day and then commented on how it it went. I don't remember any of my goals except for the last day ("get discharged"). Other patient goals included things like "talk to someone if I get angry", "tell someone when I'm having symptoms", "write in my journal."

I didn't get anything new from the groups (link to the program's group descriptions), I was already familiar with the techniques they discussed/used. When I'd answer questions posed by the counselor (the instructors were all some kind of licensed counselor, therapist, or social worker), they tended to give me looks that said, "What are you doing here?" The groups were generally what you expect and not that different from how movies and TV might depict a group therapy session. You sit in a circle, you take turns answering questions or sharing something about the class topic, you can choose to participate or not. Responding to other patients was my favorite part. I liked feeling supportive.

One group that stands out in my memory is music therapy. We listened to the song "Amazing" by Aerosmith and none of the patients agreed with the counselor's analysis. He kept saying that rock bottom is only something you can hit once. Everyone else felt like it was possible to get there more than once in different ways. He insisted that if you thought you'd hit rock bottom before, it meant you hadn't really. I think we were all wondering, "Have you even been there?" Ultimately, I don't think it matters if "rock bottom" is something you experience once or multiple times, it matters that you don't try to invalidate someone else's experience.

I did one dance class, which must have been something like interpretive dance. I felt incredibly silly, but figured I might as well go all in. It's not like I would see these people again, so no reason to feel embarrassed. There were some art therapy classes too so I went to those and doodled. It made me think of the written and drawing journals I used to keep as a teenager and all the little emo girls I used to draw on those pages. I had a character called She, very much an author-insert character, that I drew little comics about. I don't think I ever showed them to anyone or told anyone about her.

Aside from the groups, we had a lot of free time which we spent socializing with other patients or basically just vegging. Unless you were having a rough time mentally/emotionally and then you were... I don't know. Struggling. At any given time, we all were to some degree otherwise we wouldn't have been there.

To be continued...

Sunday, October 21, 2018

I was hospitalized (part 3)

Continued from previous entries: first, second

Content warning for psychiatric hospitalization, thoughts of suicide, overdose, and overall depression.

On the first day, I learned the general schedule and expectations for my stay at the unit. First thing in the morning, we were woken up before breakfast, served at 8:30 AM, if we weren't already up. Our vitals were checked before we went to eat and I became very familiar with my normal blood pressure numbers. The food was pretty crappy, think eggs and sausage at a continental breakfast in a cheap hotel. All the meals were similarly bad. At the time, I was attempting to stick to a gluten-free diet to manage digestive issues and the staff said they could accommodate this. I feel like I don't need to explain to you that they never ended up getting me those meals from the unit across the hall, which was for eating disorders. Some of the patients told me that the other unit had much better food overall. I found that morbidly funny. I drank water at meals, though we could also choose soda and juice, I believe. I started having coffee in the morning just for something different. It felt like bonding to drink coffee at a table with other patients, a slightly romanticized experience. Plus, I was tired and the caffeine helped.

One thing about beverage options: we didn't have regular access to water to drink. Some patients had big plastic cups that they'd refill at a pitcher on the front desk. You know those giant cups they give you in hospitals with the big straw? I asked for one several times. At the time, I was used to drinking close to 100 oz of water every day. Suddenly, it was only 24 oz at most, from water at meals and little plastic cupfuls every now and then. I got headaches and felt light-headed most of the time I was there. Soon after I got out, I got a UTI. I'm still mad about that.

I saved this picture sent from a friend around 2004. I still love it.

I met the resident prescriber (a nurse practitioner that we called Dr. Love) on the first day. He seemed angry at the doctor that sent me for prescribing Remeron. Dr. Love was not a fan of it. He put me on Wellbutrin (Bupropion) instead. He also prescribed an anti-anxiety medication called Vistaril to take PRN (I never found out what that meant, but I guess as needed) because coming off the Remeron might make me extremely anxious for a few days. The first time I took Vistaril, I slept for the afternoon. I didn't like feeling that lethargic, I associated that level of fatigue with my Remeron experience, so he switched me to Neurontin (aka. Gabapentin). It made me feel like my head was floating away which I didn't particularly enjoy, but it silenced all the anxiety in my mind. Having that kind of relief for the first time ever was incredible. I remember sitting on the couch the first time I took it and chatting happily with other patients, amazed at all the thoughts I was able to process without the background noise of constant anxiety. Medication was dispensed at a window along the entry hallway and we were called up individually since we all had our own unique schedules depending on what we were taking. No one asked to see in my mouth to make sure I'd taken my medication, but I was viewed as high risk in any way.

(Other medications I received: some high doses of Vitamin C when I told them I was starting to feel sick, a laxative, Benadryl to sleep at night, more doses of Benadryl if I still couldn't sleep after an hour or two. I took Benadryl every night.)

At some point, I learned that you could make phone calls from a phone dedicated for patient use anytime you wanted. You could also receive calls there, though it was awkward to answer the phone for someone else ("You're looking for Joe? [to room at large] Hey, who is Joe, you have a phone call!"). My cellphone could have been turned in at the front desk and kept in a safe or I could give it to my husband to take him. He took it home, but I regretted that later when I needed various doctors' numbers. The only other outside-world social interaction was during visiting hours, which was sometime late in the day.

At this point of retelling my story, I have to refer to the handwritten journal I kept while I was hospitalized, as the specific details and order of events are fuzzy. I had seen another patient writing in a Composition notebook and they told me I could request one at the front desk so I did. I wish I had written in it everyday, but it appears that I arrived on a Tuesday evening and did not begin writing until Thursday.

To be continued...

Friday, October 19, 2018

I was hospitalized (part 2)

Continued from previous entry.

Content warning for psychiatric hospitalization, thoughts of suicide, overdose, and overall depression.

I had no idea what to expect from being in a "psych ward." I was pretty scared, but also still mentally checked out. I pretty much just did whatever anyone told me to, which I've found to be my ultimate survival mechanism. Like when I went skydiving! The instructor that I was strapped to told me after that I did really well listening to him but really it was the only thing I was capable of doing. I suppose that's not the worst thing.

Everything at the ward was basically how I expected, but more boring. It wasn't like what I've seen in TV shows, not nearly as stark (or clean).

Look, a sad person.

The intake process at Walden Behavioral Care included the steps below, plus more probably that I can't remember. These are probably not in chronological order.

  • This bit I do remember as it was the first thing I did: I was taken to a small room with a couple of staff members and given a quick examination after stripping to my underwear. They wrote down how many tattoos and visible scars I had and their locations. They asked me how many tattoos I had, but no matter when anyone asks, I always have to look down and count (it was 7 at the time, I think).
  • I was shown my "pink paper", the section 12 application, and informed that it would be discarded if I voluntarily committed myself (YOUR RIGHTS REGARDING ADMISSION TO AND DISCHARGE FROM A HOSPITAL UNDER MASSACHUSETTS MENTAL HEALTH LAW Prepared by the Mental Health Legal Advisors Committee). Of course I did this, I was afraid of the involvement of courts and lawyers. I thought I might be able to get out sooner than the legally required 72 hours (three business days), but this wasn't explained clearly: I was not allowed to leave when I wanted. Later, I was told that I would not be able to leave until they could confirm I had a follow-up appointment scheduled with a psychiatrist and therapist within a week or two.

"As a conditional voluntary patient, you remain on this status, until the hospital decides to discharge you, you ask to leave by filing a "three day notice," or the hospital decides to pursue commitment." (source linked above)

  • They let me see my husband briefly and retrieve my clothes from him. He made a list of clothes and toiletries to bring back, like my dye-depositing conditioner to maintain my teal hair (very important, obviously). Everything would be examined for no strings, no belts, and no sharp objects. This meant I couldn't use my deodorant in a glass jar, so I stuck with the free shit from the unit. They started taking the laces out of my Chucks until I told them I'd rather just walk around in socks. I could leave my Chucks behind the counter to put on for walks outside. He also brought me the Harry Potter books and I started re-reading the series during my stay.
  • After saying goodbye to my husband, I was shown my plastic-wrapped bed, in a large plain concrete room much like a prison-like motel, and small bathroom with somewhat faulty shower. There was an inspirational quote on a chalkboard on the longest bedroom wall, which I never wrote down, but found heartening. A previous patient had written it there. I got some cheap toiletries from the staff (worse than the cheapest motel toiletries you can imagine) and was grateful for the deodorant as stress had left me disgustingly odorous. At some point, I was introduced to my roommate. My only clear memory of her was that she seemed young and rebellious. She may have said, "I don't belong here." I think her stay was court-appointed. She would later splash water on the chalkboard, ruining the quote.

My impression of the facility overall was that it seemed relatively clean, but dingy, outdated and worn. You could describe most of the staff there in similar terms. It seemed like every room could use a fresh coat of paint and all the furniture should be re-covered. It would do wonders for the mood of the place to brighten up the colors if not the decor. I kept to myself at first, watching TV from a distance and looking around. I was too nervous to speak to anyone. I went to bed pretty early, just to pass the time.

To be continued...

Wednesday, October 17, 2018

I was hospitalized (part 1)

This story has been calling me to write. It's been three years now and it seems now that it's time for me to talk about it. A fair amount of people in my life may know that this occurred, but probably little other details. The only people who know most of what happened are my husband and sister, who were there for me in any way I needed during that time. For that, I am eternally grateful.

In October of 2015, I was hospitalized against my will in a psychiatric program for about 5 days.

Content warning for psychiatric hospitalization, thoughts of suicide, medication overdose, and overall depressing experience.

With the way my memory works, I can only tell you that I remember having an increasingly hard time staying afloat. As the year continued, my mood tended to list more and more towards almost always depressed. I wasn't sleeping well. I couldn't concentrate. I wasn't enjoying much. I don't think there was something specific going on, just one of those extended periods of time in my life when my brain needed some extra help. I finally accepted it in the summer and sought out psychiatric help in the form of medication. I'd been off of any kind of psych meds for at least a couple of years, feeling very much in those years that they were only harmful to my quality of life and suppressed my ability to enjoy life while dampening the experience of depression. I had tried many different supplements to manage the depression back then.

Days before hospitalization (teal hair)

I've written a little about acquiring this new medication previously. It took some time to be seen (end of August), but I found a new doctor and was excited to have the opportunity to tell my story to someone new, having seen more than a few psychiatrists since I was first diagnosed with depression in 2004. I was happy to have the opportunity to say "I didn't like how all these SSRI's worked for me" and try something new. It's not uncommon for users of SSRI's to report that they feel their personality is muted or that while the depression is lessened, their overall experience of life is too (can't feel sad, but can't really feel happy either). The doctor told me there were other types of anti-depressants available to try, like SNRI's. I was prescribed Remeron.

The doctor advised that I should take it no later than 30 minutes before bed and not to get up after taking it, as it would make me very tired and possibly dizzy. Early on, I did get up a couple of times to use the bathroom and it was pretty scary. At the time, we lived in a 2nd floor apartment and you had to pass the open stairwell to get to the bathroom in the hall. I clutched at door frames very carefully. Even in the day, I was pretty tired. Weeks passed and I wasn't sure I felt much better yet, the fatigue was overwhelming.

I must have taken Remeron for close to a month. The doctor told me that this medication takes effect much faster than SSRI's, which can be about 6 weeks before you feel the positive effects (side effects crop up much sooner). At some point, I had bedtime thoughts while staring at my bottle of pills remembering my first hospitalization. "If I take more, maybe I can go to sleep and when I wake up, everything will be better." The same thoughts I had in 2004 before my partial hospitalization (and that time I did try to overdose). This time, they were just unwanted intrusive thoughts and I didn't think I'd act on them (again), but in the interest of honesty, I told my doctor during an appointment soon after. She was alarmed and told me she recommended emergency hospitalization.

I argued against it, telling her I felt safe enough, but as she continued insisting and essentially told me I had no choice, I started crying. She let me call my husband and have him take me to the ER, where they'd be expecting me. From there, I'd be taken to an available psych program (availability dependent on a "bed" i.e. space in the program). I didn't understand the implication at the time, but had I not turned up at the ER, there may have been legal repercussions (Emergency restraint and hospitalization of persons posing risk of serious harm by reason of mental illness aka Section 12, Massachusetts law). My poor husband didn't understand that I was being told to do this against my will, but it's probably for the best, as he never would haven taken me otherwise. I felt numb.

Thus began hours of waiting in a private room in the ER, bored in a hospital gown, eating crappy ham & cheese sandwiches, while they tried to find an available bed for me. I think I read some graphic novels on my smartphone and my husband kept me company the whole time. I wanted to let someone in my family know what was going on, so I texted with my sister. As I usually do for comfort, I tried cracking jokes with any medical professionals that came by for tests, probably confusing them a little as I was supposedly massively depressed. Finally, they found an opening at Walden Behavioral Care and they made me get transported by ambulance. My husband followed in his car. The guy in the ambulance was friendly and asked about my Sabriel tattoo. It was my first time being totally aware during an ambulance ride (and only my second ambulance ride ever) and I realized you could see out the back window while sitting up on the gurney. I wondered if anyone could see me.

When we got to the facility, they wheeled me down a hallway with some pretty dismal paintings of flowers. To this day, my husband rags on me for missing a golden opportunity to say "Wow, those are depressing." So there you go, I shared the joke with somebody.

To be continued...