Wednesday, September 7, 2016

The Episode That Started My Cyclothymia Journey

Seven years ago today, I was hospitalized. A few months prior, I had gone to my GP to discuss what seemed to be depressive symptoms. Why I didn't make an appointment with the most recent therapist I'd seen on and off over the years, I'm not sure. But I didn't, and therefore was given no diagnosis, just a mild dose of antidepressants. It had taken me a lot of courage to accept the medication. For years, despite going to numerous therapists, I'd never been prescribed medication. All but the most recent (who is still my therapist today) had told me the opposite - nothing was wrong, I was just going through "life stuff", more or less. It was entering the "real world" after college, planning my wedding, my marriage, my mother-in-law (this could have been legit),  etc. It didn't matter that some of the emotions I'd experienced were far from what I felt was "normal". It didn't matter that at times my then-husband, much to his credit and my amazement, would hold me so that I could punch and kick the air to release anxious energy to the point of mental and physical exhaustion. Only the most recent therapist had taken me seriously and to be honest, I hadn't done her justice. When I'd begun going to her, it was both for some body image issues/discorded eating, and in the wake of my divorce. When I'd entered my new relationship, I'd felt better on both accounts for quite some time - a "love high" so to speak - and figured maybe everyone else was right. So I kind of fell off the therapy wagon.  It had only been recently, as life settled down a bit, that the darkness had begun to seep back in, and I'd made the appointment with my GP.

The antidepressants seemed to work, at first. I didn't have the looming heaviness that seemed to continually be there, even if in the background. But lately, I'd been having an increasing amount of, what seemed like at least, anxiety. The feelings of needing to desperately release anxious energy had returned. I was starting to have an increasing number of what I thought were anxiety and panic attacks. Finally, on Labor Day 2009, I could no longer stand it. I knew something was wrong. My then-fiance took me took me to the ER. We thought perhaps they could give me some sort of an answer, or at least point me in the right direction. In a round about, convoluted way, I suppose they did.

At the time, they were of absolutely no help. They told me they could do nothing. When I said something was quite wrong, they replied that I could stay overnight if I wanted, but they didn't have room so they'd have to send me to a sister hospital. I was at Virtua, so while I didn't love to have to go elsewhere, I figured there were enough Virtua hospitals and it had to be nearby. Why I didn't ask, before I signed the papers, which one, I am not sure. In the throws of a severe anxiety attack, I simply agreed. I needed someone to help me, and if that meant I had to sleep there overnight to be seen further so be it. What they did not tell me, in my confused and ill state, was what that actually meant. They simply gave me some papers to sign and dutifully, I did. As the process for me to move began, I realized something was terribly wrong. We asked for the location, so we knew where we were headed, and they told me that they had to take me themselves. In an ambulance, on a gurney. They assured me it was procedure. My fiance followed in his car, thinking he'd be able to stay with me, or at least see me settled in if he wasn't allowed all night.

When we arrived, I was given a set of instructions:
  • Visiting hours were strict, and not often. 
  • No cell phone use was permitted, at all. To call anyone I needed to use the house phone. 
  • I had the right to leave, if I chose, after two nights, because I was a voluntary check-in. 
Now, I knew something was very wrong. I asked, for the first time, where I actually was. I was not in another branch of Virtua. I was at a mental health hospital that yes, did have some connection with the brand, but it certainly wasn't what I'd been lead to believe.  I told them I'd change my mind, I didn't need to stay overnight. They replied that I'd already signed the papers, so they could send me back to the ER, but if the ER decided to admit me involuntarily then I would have no say over when I left. My fiance and I discussed the options. The thought of being trapped against my will for any longer than two days, when I had not actually agreed to be there in the first place, was unbearable. I agreed to be 'voluntarily admitted'. I figured perhaps, after all, they would be able to offer me some help - to figure out, finally, what was going on. 

I say, "I decided to go", but really, I made big fuss about it, once up in the actual hospital. They confiscated my purse. I would get it back when I left. They took my belt. They then told me I needed shorts that fit better (I told them they had, before they took my belt). I'll admit, I probably didn't appear the most promising patient. But I was still battling the anxiety and panic that had sent me to the ER in the first place, and now had been coerced here against my will. I felt like a trapped animal. 

They had me sit down with a completely uncooperative therapist, who basically wouldn't listen to anything I said. He insisted I was battling depression, upped my antidepressants, and labeled me a suicide risk. I asked why, since I'd come in with anxiety attacks.  Apparently, they'd not liked the answer to a leading question they'd asked in the ER. I found it ironic that they'd labeled me a suicide risk at the ER, yet had been ready to send me on my way, with not so much as asking if I planned to follow up with a therapist, or even had one, until I told them I really needed to at least be seen further (which was when they told me I could stay overnight and the rest began). 

All of this said, my time in the hospital - I did leave two days later at will - did help me in a few ways. 
  • I learned that there were a lot of people there just like me. There were people misdiagnosed or undiagnosed but seeking some help; persuaded against their will by the hospital; people battling extreme grief (luckily this was not me). Most of us were drastically far from what the movies portray as "mental hospital patients".  We were "normal" people battling something medical, known or unknown and looking for help in treating and living with it. 
  • I had the experience of group sessions. While it's not something that I traditionally do, it gave me a different perspective, and I got to know the others there. 
  • I reconnected with my therapist on the outside world, and began seeing her again. It was she that realized shortly after that my antidepressants had thrown me into hypomanic episodes, not anxiety or panic as I'd thought, and that I actually had the rare diagnosis of rapid cycling cyclothymia. She weaned me off of the antidepressants, and slowly introduced me to a mood stabilizer. I've been seeing her regularly, and taking the mood stablizers ever since. 
I don't share my story to discourage people from seeking mental health help. In fact, it's quite the opposite. This visit to the ER, despite how much I despised the staff at the time for tricking me, and despite the fact that I did not like the specific doctor on staff, ultimately helped me. It got me back to my therapist, who I should have been going to in the first place, and therefore allowed me to be diagnosed and begin treatment.  I also learned some valuable lessons along the way:
  • Ask questions. It doesn't matter how silly you feel, or how many you ask. Never assume. 
  • Insist on a diagnosis,  prognosis, or at least next steps. If they don't have a diagnosis yet, make sure you know what they plan to do every step of the way until they have one. Ask for a plan in advance before agreeing to anything.
  •  Have a plan for your mental health care and make sure that a few trusted loved ones know of it. You may not be in a state to ask questions, to properly sign documents, to discuss your plan with the doctors or medical professionals at the time. Have people assigned, in advance, who know what you want. Make sure they know who each other are, and what each person's role is. You don't want them to guess or put them in the position of arguing against each other, each suggesting what they think you'd want them to. 
  • There are other people out there like you. You are not alone, no matter how rare your disorder is (the prevalence of rapid cycling cyclothymia is something like .04% of the US population). Seek out those people, who can give you something to hold onto, when nobody else can understand what you're physically and mentally going through, no matter how hard they try.
  • You can get through a hell of a lot more than you think you can. This was not an easy time for me- the hospitalization, the diagnosis, weaning off one med, starting another that made me horribly ill initially, adjusting to learning that I have a life long mental health condition. But I got through it. 
  • It is worth it. By it, I mean pushing through these episodes, these awful times. My life has changed drastically since then, in just about every way. But I am still here, and I decide to wake up every day because it's worth it, no matter how hard it gets. 
  • Being diagnosed with a mental health condition does not take away your voice. It gives you one. 

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