I’ve spent most of this summer in and out of the psychiatric hospital parking lot. My husband spent most of it behind the metal detector where they make you strip out your pockets and take the laces out of your shoes. It has not been Barbie’s Dream Summer™. Knowing how the craziness (both medically and vernacularly) can be overwhelming, I wanted to write a quick help list to keeping your head above water for any of you who also find yourself in this situation.
All storylines will be different but there are elements of my particular situation, a spouse with Major Depressive Disorder and multiple suicide attempts, which would and could also apply to other mental health inpatient situations. This is focused on caretakers. Your loved one will be under the care of professionals in the hospital setting. You did your job getting them to help and now you need to survive the storm. Here are some things that kept me afloat.
1. For the staff, this is just a Tuesday. They will seem horrible and cruel and surprisingly unbothered by what is most likely the second most terrible day of your life. Checking into a mental hospital is a bizarre combination of going through airport security, checking into a motel, and entering a nightmare world where people calmly respond to the most important person in your life explaining that they planned to buy a gun. Without any irony, one doctor (via webcam because the process took so long that it was three hours past normal office hours when we got to the “see a doctor” step) mimed placing a pistol in his mouth and the resulting explosion with hand gestures.
Another doctor referred to a patient who committed suicide as “breaking his winning streak”. There are stupid procedures and passwords and rules and regulations about everything. This is not their fault. Their job is to provide a dampening effect on the raging emotions of patients and caregivers by casually indicating via body language, tone, and word choice that everything is acceptable and that there is a calm and rational solution. You are still allowed to hate them for it.
2. Make friends with the secretary. You will see her every day, sometimes twice a day. There are visiting hours, package drop off, insurance paperwork, billing, and a terrifying amount of pharmaceutical jargon. She will be the gateway to every solution. Bring her tea. Remember her name. Remind yourself that her job includes people screaming at her, going into withdrawals at and around her desk, and asking people 100 times a day to confirm the patient id number so that she doesn’t accidentally ruin someone’s life. She also watches people do the shameful security pat-down, hears awkward jokes about bra wires and belts, and reminds people that keys are metal… every single day. Wait for the chaos to die down around visiting hours and ask direct open-ended questions. Then wait. And smile. Eventually you will get what you need. (Still expect weeks of delay. Literally weeks.) Ms. Tasha told me about her son’s speech pathologist, the baby shower she is planning for a coworker, the woes of braided hair, and held me when I broke down weeping after yet another piece of paperwork came back completely wrong and useless. If you are kind, they will be a shining spot of normal calm chitchat in the middle of the overwhelming chaos. Treasure them.
3. Get organized. Psychiatric hospitals highly highly value patient confidentiality. They restrict access and information based on patient ID numbers and colored wristbands. They change the ID numbers every month, and for billing purposes for every separate procedure. In fact, they are so big on privacy that they could be role models for the Biblical injunction on clandestine generosity. This unfortunately plays into “the left hand not knowing what the right hand is doing.” You need to document the hell out out of everything. Keep every paper they give you. Get a calendar just for this. Write down entry dates, exit dates, therapist names, and the godawful alphabet soup of pharmaceuticals. They will change dosages, therapies, and a swarm of angry acronyms that mean nothing to you. Write it down, hand it to someone you trust, and have them Google the crap out of it while you (hopefully) sleep.
Example: My husband was prescribed electro-convulsive therapy (which sounds terrifying and One Flew Over the Cuckoo’s Nest– ish but is actually an incredibly controlled and focused treatment). They put him under for five minutes and cause a short seizure in his brain. Side effects include memory loss and temporarily decreased motor skills. No one knows how it works or why. It may rewire the neuron pathways or somehow stimulate blood vessels but researchers aren’t sure about the mechanism. It’s safe and highly effective. I believe it’s had a major stabilizing effect on my husband. Here’s the deal, though, 12 sessions is generally considered an extended program. Many people stop at eight or nine. My husband was on session 10 and checked to see when his last two appointments would be only to discover that he was booked for another ELEVEN sessions. They forgot to account for the sessions that had been performed while he was full-time inpatient, in the same clinic, with the same doctor, on the SAME PATIENT. If it hadn’t been for the patient, who let me remind you is at risk of retroactive and antereograde amnesia, double-checking his record post-seizure, they would have happily continued frying his brain every other day for another month. Record everything.
4. Go shopping. Along with getting organized, you’re going to need some new gear. Here is my shortened list of essentials. Get a calendar with enough space to write notes like “Dr. C recommends ECT. What the hell is ECT.” Make sure it is small enough to fit in your bag, back pocket, or whatever you clutch in a crisis. Get a good water bottle. Mine has hourly goals marked on the side and a bouncy motivational quote with a little basket to infuse fruit flavors into the water. Go hard core with a Yeti or adorable and floral. I don’t care just something that you will actually grab. You will be crying far more than you realize and dehydration makes decisions difficult. On a related note, stock up on granola bars- the ones with real nuts and fruit and chunks of chocolate because you will either forget to eat or realize you’ve had nothing but drive-thru fries for two days. Buy yourself some sleeping pills. Your bed will seem empty and you will spend nights staring at the phone praying that it doesn’t ring telling you that he’s attempted again. Sleep will help and Tylenol PM is your friend. Also on your shopping list: things that make you feel good. I bought fancy Lush bath soaps, a cellphone cord so I could listen to my calming music in the car, and a plant that bloomed bright yellow Those coloring books and nice pencils are a good idea too. I bought soft yarn to crochet and feel for tactile comfort. I drank more milkshakes than any rational person needs. You are not rational. You are in crisis. Be kind to yourself.
5. Self-care. Simplify. Shut down. I know you are on Buzzfeed and Instagram and Facebook and EVERYBODY TALKS SELF CARE. But seriously. This is critical. You will have one hour a day to visit your loved one in a room full of other people in crisis. You will have family and friends looking to you for advice and decision making and information. You may have a child who is very confused about why their Dada is not home anymore. You are both a victim and a first responder and I wish I could give you a handbook and a hug but I can’t. Hold on.
You need an oxygen mask now more than you ever have. Find a counselor, or better yet, ask a friend to find you a counselor so all you have to do is simply show up. Take the sleeping pills. Ask a friend to hold your phone and go into the other room and cry. Practice breathing carefully. I would breathe in for four counts, hold for four, and release for four. Wiggle your toes and take a minute. Your body wants you to be okay. That water bottle and granola bars are for you. So are the milkshakes and the comfort food and the third cup of sweet tea in one day.
It is okay to find good in the superficial and mundane. In the moment, no grand goodness seems possible but hold onto the little pebbles that sparkle. Give yourself permission to only plan the next three hours. Some days I had to take it down to thirty minutes. That’s alright. The world is changing rapidly and slowing down is counter-intuitive. Find space to be quiet. For me, it was morning prayer at our church. There was a rote procedure that was rich in meaning. There was no one there besides the rector and myself. I could cry and sit and be angry and scared and overwhelmed. Then you get up and keep moving.
For simplicity’s sake, I created a private Facebook group to update people on the situation. Maybe it was tacky. I don’t really care. It saved me countless phone calls rehashing the same trauma and ensured I didn’t forget anyone. It was a place for our community to love and encourage me, to send notes to my husband, and to comfort each other. It was also useful to use as a curated processing place. It wasn’t a place to dump all of my feels but to try and present a balanced and accurate evaluation of what was happening with a focus on hope. It’s good to choose to hope.
6. Ask for help. It’s hard. I hate it. I love giving help and I hate receiving it. It’s hard to come up with lists of things people can help you with when you are so overwhelmed that you can’t remember your middle name (I literally at one point stopped and asked my aunt what my middle name was because I was panicked that I was filling documents out wrong).
Let me give you some ideas. Write a phone list. I wrote myself a six person list by category: who to call when I’m angry, when I need psychiatric insight, when I need to cry, when I need practical next steps, when I needed a distraction, and when I needed someone to tell me I was a boss and that everything was going to be okay. Tell people who they are on the list. Let them do their assigned job. My friend Jo has cussed out every asshole doctor I had conversations with, and my sister-in-law Rebecca showed up with cleaning supplies and cookie dough. Everyone loves in different ways. Let them.
Ask people to spend the night with you. Some of the only sleep I got during the 28 days my husband was in the hospital was with someone else in the apartment, watching my phone and letting me take a sleeping pill without worrying that I would sleep through the baby crying. Accept the food. If you live in the South (in the USA), people will bring you food as a first reaction. Take it. Try to eat. Don’t feel bad about throwing it out. Remember that everyone will say perfect things, well-intentioned things, and stupid hurtful things. EVERY SINGLE PERSON. Let it go. Try and absorb the good love that they are trying to say and ignore the sentences that break your heart. You’re going to say things you regret too. Forgive yourself.
Talk to your counselor. You have the right to feel heartbroken, betrayed, angry, and hopeful. All of those things can be true at the same time. I felt the desperate wild love for my husband at a level I’ve never felt before and it came at the same time as I cursed him and God for shattering my heart and destroying my safe stable life. There will be days where you feel fine and feel guilty for enjoying a Target run or laughing at a silly face your baby makes. There will be days where you don’t recognize your own face in the mirror because surely you haven’t aged ten years in a night. A counselor can help you sort through those feelings and keep moving towards balance.
Conclusion. I pray for each of you that you never experience this. But with the real prevalence of mental illness, I hope that you have people and programs that will come alongside you and help you through the hard seasons. If you don’t have a community, reach out to a local DBSA (Depression Bipolar Support Association). Those of you who are married, please PLEASE create a crisis folder. Collect all the vital documents, passwords, bank statements, and a quick list of vital information. You do not want to be gathering that in the middle of a crisis. All of this will hopefully help ease the pain but please remember.
Love is worth giving. I vowed for better and for worse, in sickness and in health. It is still worth it. It is still good. Peace be with you.
HANNAH ROBERTS is a TCK-turned-reading-teacher who lives in Texas with her husband and son. She gets disproportionately passionate about literacy, equal opportunities, and The Lord of the Rings. Her main writing focus is poetry and you can read more of her work at Dear Void.