Adventures at the Funnyfarm

(Christina here…)

Two days ago, I drove myself to the St. Anthony’s Hyland Behavioral Health Center in St. Louis. I finally decided to try to fix the broken part of my brain: I have Depersonalization/Derealization disorder (DP/DR) and Attention-Deficit Disorder. I’ve written a bit about my personal experiences with DP/DR  here.  You’ll probably want to read that if you haven’t yet, otherwise you won’t get a complete picture.

Sometimes, when you have an awful thought festering in your head, you can strip that thought of its power by saying the thought aloud. By believing that the thought is too terrible to say aloud and must remain bouncing around between your ears lest people think you crazy, you give the thought significance and power.

At other times, the opposite happens. In my late teens and early twenties, I dated someone for six years. We lived together for the last three, and during those last three years, I kept a thought to myself: I don’t think I loved him.  I kept that thought to myself, not wanting to give it reality. Once I told someone, the thought became very real, and I ended my relationship with him a few weeks later. One of the most infuriating things about having depersonalization/derealization disorder: anytime I talk to anybody about, write about, or acknowledge my feelings of detachment, the feelings implode, causing me to sink deeper into myself.  I give my thoughts power. I worsen my own mental illness. Yet, I must talk about them for the good of myself, and walk to talk about them publicly for the good of others.

Back when I saw a psychologist (in 2008, a few months before I began blogging), I felt the sense of giving my illness power very acutely. Her office was like dreamland to me – like an out-of-focus flashback in a bad movie. The more I talked, the more detached I got.. She analyzed me, and I analyzed her analysis. She wanted to talk about my childhood. I did not.

My parents didn’t abuse me by any sort of legal definition, though they did employ corporal punishment. In grade, middle, and parts of high school I was seriously mocked and bullied. The daily, constant message I heard for years from my peers was that I was ugly and worthless. Once, in sixth grade, I decided to write down a single day’s worth of insults aimed at me on a sheet of notebook paper as I heard them. I filled every square inch of the page, front and back, in tiny handwriting. Boys randomly drop-kicked me in my middle-school halls from behind. Girls, giggling, tried to set me up with the smelly boy in class who probably had autism (and assuredly was having a worse time than I).  I felt worthless and ashamed of every aspect of my personality. I wrote hateful, self-destructive messages to myself on the underside of my desk while curled in a ball on the burnt-orange carpeting in my bedroom: “Nobody will ever love me.”, “I am ugly”, “Nobody cares about me”. Only in high school did I find other freaky outcasts to band together with – kids who loved drama club and philosophy. As I came out of my shell and learned basic social skills, the teasing gradually stopped and stopped having an effect. Now, people describe me as: outgoing, pensive, willing to listen, able to take control and lead in conversations, etc. Hooray for neurodevelopment!

I didn’t think my childhood had any relevance to my depersonalization now, and I didn’t see how combing over the details about my childhood would help. I only saw the psychologist for a few sessions.

I won’t describe driving to the behavioral health center as an act of bravery. Nor would I say I acted out of desperation.  More like, I acted out of procrastination.

I stared at the number for the St. Anthony’s Hyland Behavioral Center for… days. I literally had the web page tabbed on my laptop for over a week. I would click the page, read it, then do something else – anything else – to avoid putting the phone number into my phone and dialing. I have to check this blog. I have to write this very post. I have to call the contractor to fix my house. I have to feed the German Shepherds. I have to put on socks. I’m hungry. I’m thirsty. I have to pee first. I forgot to put the soup away. On and on.

I was frozen. I finally told JT.  He urged me via IM: “Dial the number.”

I sighed and checked my email 200 times. An hour later, I dialed it… but then added it to my contacts list rather than clicking, “Call”.

Eventually I called. The lady on the other end of the line told me I could just walk in, that they didn’t take appointments. But…

“For an assessment, patients may make an appointment by calling 314-525-4400, walk in or be referred from St. Anthony’s Medical Center.”

Lies!

Without an actual appointment, I might not go. So I made JT tell me I had an appointment. I know that sounds pathetic, but I’m adept at getting things done when people have expectations.

“Christina, you have an appointment at 6. I’m calling you at 5:30.”

I felt nervous: an odd and alien sensation for me, as if preparing for curtain call for a play.

At 6pm I pulled into the parking lot, turned off my car, and sat in the dark, stalling. I checked my email. I checked Twitter. I read Wikipedia entries. I watched people walk past my car; a young woman with black dyed hair and plaid pants, a woman carrying a box full of something. Half an hour later, I told myself to get out of the car and walk in. So I went.

Photo of christina in the car, on her smartphone

Stalling... self-portrait.

Inside the lobby, I passed a man in a wheelchair, wearing a hospital gown, with obviously fresh bilateral above-knee amputations. He sat with someone in blue scrubs, presumably a nurse. A couple sat in chairs, their coats and hats on, talking softly to each other. I walked to the receptionist, who took my name and directed me through two double doors, down a long hall, to another receptionist.  The second receptionist knew my name already when I approached the window, and handed me paperwork to fill out. She smiled pleasantly. Almost too pleasantly. I thought about what kind of job training she must have had, her sitting alone in a boring office watching tired old orientation VHS tapes. “Make sure you greet every patient cheerfully…”

One guy in full scrubs with surgical booties sat in a chair nearby. He pretended not to eye me for five full minutes before shuffling to his feet and walking off. Perhaps he worked in another part of the hospital and decided to take a break here, or maybe he acted as security. Meanwhile, I felt observed.  In graduate school, we learn as occupational therapists to observe our clients, from their mannerisms, to the way they dress, to how cluttered or clean they keep their living spaces. From the moment I walk in the door, I’m evaluating. Now, I had eyes on me. I hated it. I made me feel less real and more disconnected. I desperately wished for my bed, so I could curl up so no one could see me but myself. I told myself to act normal – to avoid shifting around in my chair, avoid avoiding eye contact.

If I came to the hospital due to trouble breathing or an oozing wound, I would not care who saw me. I enjoy spotlights, giving workshops and speeches. I enjoy having an audience when my potential craziness is not the topic.  So why should I treat mental illness any differently? I shouldn’t, but society has foisted upon me certain ideas about mental illness which one cannot easily forget.

A fan in the ceiling of the waiting room made a comforting white noise. Pictures of calming scenes; trees, woods rising from a creek bed, hang on the three and a half walls. I wonder how many people feel calmed by these pictures, and how many people look on them in analytical disdain. I worry. If I smile, will they think I am faking it? How long am I going to be in here? What kinds of tests will they give me? How much will this all cost? Will they tell me that I have nothing wrong, that everyone experiences this, that I should just go home and stop thinking so much?

Photo of Christina in a waiting room

Waiting. Self-portrait.

 

I have a great life, really. I feel stupid complaining, feeling numb, feeling like a  homunculus, feeling empty all the time.  My life should comprise the pebbles and ants on the sidewalk, but I’m driving by in a car with the windows rolled up. Rationally, I have no reason for my unhappiness. But DP/DR takes away my ability to reason about happiness. All the reasoning in the world won’t make me happy or feel real. I can tell myself all day that the things and people in my life are real, but they still don’t feel that way. I can tell myself all day that I should be happy, but I’m not.

After waiting about 15 minutes, a social worker called me into a smaller room. In this room, someone had arranged five chairs in a circle.  After taking my temperature and blood pressure, she sat in a chair and asked me questions for an hour.

I can talk about events in my life and crazy ideas in my head without crying or becoming upset, completely detached from them, because I’m telling a story that does not belong to me. Aside from the usual questions about my occupation and hobbies,  the social worker asked a lot of questions which would probably make a lot of people squirm. Had I thought about suicide? Yes, pretty much every day. Had I thought about hurting other people? Yep. Not that I want to have those thoughts – they are as sudden and uncontrollable as opening a door and seeing a corpse – it wasn’t your choice to see that corpse, and it’s not my choice to have those thoughts. I’m as in control of some of my thoughts as  one might feel in control of their own dreams while they sleep. Did I have a plan to hurt myself or others? Nope. Have I engaged in self-harm? Yes.  The social worker and I even had a discussion about body suspension and play piercing – she had heard of body suspension before, but not play piercing. We collectively decided that both of those activities did not fall under the purview of self-harm. Do I live in a safe and stable environment? Yes, quite so. Am I willing to try medication? Yes, and since evidence shows the best outcomes occur with a combination of therapy and medications, I wanted to do that.

I had a hard time not minimizing the impact my brain has on my ability to function. I wanted to tell her I was fine. But I’m not fine.

I know a lot of people out there might fear going to a mental health center because they fear the people there will decide to “lock them up”. Unless you are a clear and present danger to yourself or others (i.e. have a plan to hurt yourself or others, and plan to act on that plan) they won’t admit you. After an hour of questions, my assessment concluded.

At this point, I expected the social worker to leave and bring in a psychiatrist. Instead, she left the room and called the psychiatrist on the phone to discuss my case. I wouldn’t see him personally.

I balked – I didn’t want to leave empty-handed, with another phone number to call. I waited.

The social worker came back, and gave me these three options: 1. intensive outpatient therapy, involving coming to the center from 9-5 for a period of time until they discharged me. 2. Semi-intensive outpatient therapy, involving coming to the center from 11-5 until they discharged me. 3. Come to the counseling clinic for group therapy. 4. Take a referral to another psychiatrist.

I opted for option 4, choked back tears until I was out of the building, and then drove home crying. Two of the four recommended psychiatrists were names I had already seen before. I felt let down. Empty-handed. Untreated. I got nowhere. I finally decided I should take steps to fix my brain, and what I considered a big step didn’t get me far at all. I’m not fine and I wanted help right then. I’ve spent the last three months crawling desperately up the mountain in my brain,  and I’ve only moved an inch.

The next day, I called and made an appointment for the first psychiatrist on the list, a lady described by the social worker as a “really neat person” who does general and forensic psychiatry. Unfortunately, she can’t see me until the end of January. So, this post doesn’t have a cozy ending.

If you’re thinking about diving into the world of professional psychiatric help for your mental illness, you might encounter roadblocks. I felt defeated, but only temporarily. I have a graduate degree, and I only had to jump through 56,094 hoops to get it, so I will jump through that many hoops to make my brain better. I want people to know that they don’t have to fear mental health professionals. I want people to know that they are not alone.  Mental health is a soft science, an inexact discipline, but people are mostly soft and inexact anyway.

 TL:DR: I drove myself to a behavioral health center and left with nothing but a referral to a psychiatrist.

Reach Christina at Zizturiswrong {at} gmail [dotcom] or on Twitter @Ziztur

 

  • StevoR

    Wow. Well written and spot on. Sof & inexact and messed up and ..human. That’s us. Well a lot of us anyhow.

    Mental illness is incredibly common. Yet so few seem to realise it.

    Hope this helps.Best wishes – & happy new year!

  • Anne Marie

    As someone who’s struggled with mental health issues for as long as I can remember and been in treatment of various forms and intensities for a decade, I know how you feel. I procrastinate on making appointments and getting a plan figured out. Having a phone number is so frustrating and scary. I’ll be wishing the best for you and please don’t give up on your plan to work on this due to a setback. You’ll find the person for you, even if the process sucks. /:

    • http://www.ziztur.com Christina

      I actually hate dialing numbers much less than I do now.

      I’m the sort of person who faces a lot of fears head on instead of shying away from them. Afraid of needles? Get some and stick ‘em in my arm. Afraid of making phone calls? Get a job where I have to make phone calls at least 10 times a day. But I still hate calling if what I am doing is trying to help myself.

  • http://twitter.com/#!/VeritasKnight VeritasKnight

    I had a lot of difficulties, though I don’t think I was ever diagnosed with anything proper, when I came out of high school, and I went through more than a triple handful of councillors and psychiatrists. This is a familiar story to me.

    My least favourite part was showing up for my appointment to find that the hospital’s psychiatrist has been changed…again…for the third time. And that I have to start over…again…with a new doctor.

    It took me four, four and a half years to work through some of the stuff I had to work through. Some of it I have to keep living with. But that you can reflect on your experience like this? Inspirational. But most importantly – I hope it is therapeutic. By the end I could read a little more determination than defeat, and I think – I hope – that’s a good sign.

    • http://www.ziztur.com Christina

      “My least favourite part was showing up for my appointment to find that the hospital’s psychiatrist has been changed…again…for the third time. And that I have to start over…again…with a new doctor.”

      Ugh, that’s uncool. I am an OT myself and I would never do that to someone. Continuum of care is pretty important.

      Not gonna lie – JT has been a HUGE help. He pushes me to do what I should do, but not in a coddling or overly hand-holding way. He helps in the exact way I need a friend to help. It’s like the dude can read my mind.

      I’m hoping that writing about it will be therapeutic, because not only do I feel less alone, I feel like writing about it can help other people. That makes me feel good.

  • CC

    I’ve had similar experiences of deep disappointment after contacting a mental health professional. I imagine that by the time most people get up the nerve to call, they need help Right Then and it can be really frustrating to get nothing more out of the call than an appointment three weeks away. It gets even more frustrating if that professional turns out not to be a good fit.

    I think the analogy to grad school is apt. Getting better is going to be a marathon, not a sprint. You’ve got to stick with it. I wish you the best.

    • http://www.facebook.com/ziztur Christina

      Exactly! I was so effin frustrated… Luckily, I get over my frustration fairly quickly, so now I’m just looking forward to writing the giant check to my new psychiatrist when I see her (my insurance sucks.)

  • dcortesi

    Just curious because the differences between the options are so stark — did they say what you would DO during 6 or 8 hours of daily therapy?

    • http://www.facebook.com/ziztur Christina

      I might have gotten the house a little off… Maybe it was more like 4 or 8 hours.

      My guess (from working an internship in a locked unit for a week… boy was that a little too close to home) is that I’d participate in group therapy sessions, individual sessions, probably craft and socialization sessions.

  • http://speakingupanyway.wordpress.com Allie

    Congratulations for getting help. It takes a lot of courage. The thing about therapy is that it makes things worse before it makes things better. It’s like rebuilding your house after a fire: before you can start building, you have to tear down whatever remains from the fire and clean up the rubble. And you keep finding your things in the rubble, and it just reminds you more that things aren’t how you want them to be. But if you keep doing it, eventually you can start building toward what you want.

    Don’t be afraid to fire your doctor and get a new one if the fit isn’t right. The relationship with your therapist is more important for effective treatment than what kind of therapy they use. (I can’t find the link to the studies on that right now, but I can look for it for you if you want.)

    Also, don’t be afraid to do intensive outpatient treatment if you find that going to a psychiatrist and therapy isn’t working. Several doctors recommended that I do IOP several times, but I ignored them because I didn’t think I was crazy enough. But after self-destructing a few more times, I realized that if I wanted to have a good life, I needed to do more than rely on medication to treat my bipolar. I did 5 hours of group therapy, five days a week, for three weeks, with weekly individual appointments with a psychiatrist, a therapist, and a psychiatric nurse. It was the hardest thing I’ve ever done, but also the most rewarding.

    Congrats again on being brave enough to seek treatment. I hope it goes well for you.

    • http://www.facebook.com/ziztur Christina

      Your fire analogy is so right on. Only because my neighbor’s house burned down and melted my house. Neither my neighbors or I have been able to get our houses fixed yet, but I spent quite a lot of time over next door, helping them shift through all of their belongings, picking up the pieces.

      I believe you about the relationship with your doctor, and have no problem firing, or recommending others (like my husband!) do the same.

  • Rob

    A month is a long time to wait with that level of difficulty. Does your GP prescribe psychotropic medications?

  • Wes

    I’m sending this to all of the people I know in the mental health field.

  • http://nathandst.blogspot.com NathanDST

    First, congratulations on taking this step, finally. It’s huge, and hugely important.

    Second, just a thought on the seemingly pointless questions that therapists sometimes ask (whether about childhood or other), based largely on my own experience with Severe Depression and suicidal tendencies. You may not know what the point of the questions are, and sometimes the therapist isn’t sure the questions will lead anywhere useful, but that’s part of the process. The questions help to find out what may or may not be contributing to your illness, or what may be contributing to reluctance to deal with the illness. Once you have that information, you can start doing something useful with it. It seems to me like a variation on the Socratic method: you don’t know where you’ll end up, but the questions help to get to the heart of the matter, so you can start drawing conclusions.

  • http://snarkyhumanist.blogspot.com/ vnectar

    I related to a lot of what you wrote here, and am impressed with your willingness to share. Thanks, and good luck!